Individual provider Active NPI

Benjamin Robert Pace, M.D.

  • Ophthalmology Physician
  • Hattiesburg, MS
National Provider Identifier
1366853020
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
24607 Issued in MS
Practice address
100 Hospital Dr W
Hattiesburg, MS 39402
Phone
(601) 268-5910
Fax
(601) 264-0659
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 24607 MS Primary

Addresses

Primary practice location

100 Hospital Dr W
Hattiesburg, MS 39402

Mailing address

100 Hospital Dr W
Hattiesburg, MS 39402-1369
Phone (601) 268-5910

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5023

Other practice location 2

1711 W 20th St
Laurel, MS 39440-1802
Phone (601) 649-6506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20180619000530 MS Practitioner - Ophthalmology 3476877226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Mississippi School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Eye Clinic, P.a.Group PAC ID 4587733829, 12 clinicians

Practice addresses (Care Compare)

100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
89.54
Improvement activities
40
Cost
53.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery496
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Eye Clinic, P.a. Ophthalmology CurrentSince Jul 1, 2018 Accepting new patients
Hattiesburg Eye Clinic Cataract & Lasik Surgery Center, LLC Past Accepting new patients
Childrens Hospital of Wisconsin, Inc. Past Accepting new patients

Locations

100 Hospital Dr W
Hattiesburg, MS 39402
Phone (601) 268-5910

1711 W 20th St
Laurel, MS 39440
Phone (650) 660-1649

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1366853020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021369",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5023",
            "fax_number": "601-815-3773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 W 20th St",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394401802",
            "country_code": "US",
            "telephone_number": "601-649-6506",
            "fax_number": "601-649-6507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "24607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.