Individual provider Active NPI

Benjamin Reese, PA-C

  • Physician Assistant
  • Henderson, TN
National Provider Identifier
1295167989
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2381 Issued in TN
Practice address
1306 US Highway 45 N
Henderson, TN 38340-4003
Phone
(731) 989-9899
Fax
(731) 989-3495
NPI assigned
Aug 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2381 TN Primary

Addresses

Primary practice location

1306 US Highway 45 N
Henderson, TN 38340-4003

Mailing address

1306 US Highway 45 N
Henderson, TN 38340-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150123001294 TN Practitioner - Physician Assistant 6406170356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Family Medicine IncGroup PAC ID 8022039718, 7 clinicians

Practice addresses (Care Compare)

1306 US Hwy 45 N
Henderson, TN 38340-4003
Phone (731) 989-9899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.87 of 100Reported as group
Quality
100
Improvement activities
40
Cost
82.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2381TNMDClinical Psychologist

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 4

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1295167989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 US HIGHWAY 45 N",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383404003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 US HIGHWAY 45 N",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383404003",
            "telephone_number": "731-989-9899",
            "fax_number": "731-989-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.