Individual provider Active NPI

Benjamin Edward Adams, D.O.

  • Dermatology Physician
  • Kirksville, MO
National Provider Identifier
1376769943
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2004016406 Issued in MO
Practice address
700 W Jefferson St
Kirksville, MO 63501-1441
Phone
(660) 665-2191
Fax
(660) 626-2714
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2004016406 MO Primary

Addresses

Primary practice location

700 W Jefferson St
Kirksville, MO 63501-1441

Mailing address

166 W 1325 N
Ste 250
Cedar City, UT 84721-7794
Phone (660) 665-2198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20100224000478 UT Practitioner - DermatologyPractitioner - Pathology 2769526003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedar Dermatology PLLCGroup PAC ID 1951465806, 3 clinicians

Practice addresses (Care Compare)

166 W 1325
Suite 250
Cedar City, UT 84721-7794
Phone (435) 586-6440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision65
Removal of skin lesions2857
Removal of skin cancer175
Removal or shaving of skin growth19
Skin biopsy419

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004016406MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Dermatology Dermatology CurrentSince Feb 23, 2020 Accepting new patients
Cedar Dermatology PLLC Dermatology CurrentSince Dec 1, 2009 Accepting new patients

Locations

166 W 1325 N
Ste 250
Cedar City, UT 84721
Phone (435) 586-6440

126 White Sage Ave
Delta, UT 84624
Phone (435) 864-5591

700 S Highway 99
Fillmore, UT 84631
Phone (435) 743-5555

861 N Main St
Richfield, UT 84701
Phone (435) 558-7031

Interoperability endpoints

  • Direct secure messaging: badams@cedarderm.emadirect.md

Organizations & group practices 2

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 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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1376769943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 W 1325 N",
            "address_2": "STE 250",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847217794",
            "telephone_number": "660-665-2198",
            "fax_number": "660-626-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011441",
            "telephone_number": "660-665-2191",
            "fax_number": "660-626-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "BENJAMIN",
        "middle_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2004016406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.