NPIMap

Individual provider Active NPI

Benjamin D Prentiss, M.D.

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1346338274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
230394 Issued in MA
Practice address
Umass Memorial Healthcare
55 Lake Ave North
Worcester, MA 01655
Phone
(508) 334-1000
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 230394 MA Primary

Addresses

Primary practice location

Umass Memorial Healthcare
55 Lake Ave North
Worcester, MA 01655

Mailing address

55 Lake Ave N
Umass Medical School Dept of Cardiology
Worcester, MA 01655-0002
Phone (508) 334-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080512000023 MA Practitioner - Internal Medicine 9234218538 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-6460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230394MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Internal Medicine CurrentSince Jun 9, 2010 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Jun 23, 2011 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Dec 3, 2007 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Dec 3, 2007 Accepting new patients
Lexica Inpatient Services Internal Medicine Past Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Ste 205
Gardner, MA 01440

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

242 Green St
Fl 2
Gardner, MA 01440

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: benjamin.prentiss.1@192.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heywood HospitalGardner, MA, CCN 22S095 Hospital Corporate Director Jan 1, 2017
Athol Memorial HospitalAthol, MA, CCN 22Z303 Hospital Corporate Director Jan 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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

Hospital & facility affiliations 7

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346338274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "UMASS MEDICAL SCHOOL DEPT OF CARDIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UMASS MEMORIAL HEALTHCARE",
            "address_2": "55 LAKE AVE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-334-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTISS",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "230394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.