Individual provider Active NPI

Benjamin Douglas Ashworth, M.D.

  • Interventional Pain Medicine Physician
  • San Angelo, TX
National Provider Identifier
1255788261
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
T2110 Issued in TX
Practice address
3605 Executive Dr Ste 101
San Angelo, TX 76904-6884
Phone
(325) 747-2247
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X T2110 TX Primary

Addresses

Primary practice location

3605 Executive Dr Ste 101
San Angelo, TX 76904-6884

Mailing address

120 E Beauregard Ave
San Angelo, TX 76903-5919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713002044 TX Practitioner - Pain Management 5294021820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of North Texas HSC, College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T2110TXMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients

Locations

3605 Executive Dr
Ste 101
San Angelo, TX 76904
Phone (325) 747-2247

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

Interoperability endpoints

  • Direct secure messaging: bashworth42058@shannonhealth.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1255788261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 EXECUTIVE DR STE 101",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046884",
            "telephone_number": "325-747-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHWORTH",
        "first_name": "BENJAMIN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "T2110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.