NPIMap

Individual provider Active NPI

Benjamin John Ernst, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Appleton, WI
National Provider Identifier
1518162247
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
57459020 Issued in WI
Practice address
442 N Westhill Blvd Ste a
Appleton, WI 54914-5830
Phone
(920) 751-8666
NPI assigned
Jun 21, 2007
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 48790 CO
Retina Specialist (Ophthalmology) Physician 207WX0107X 57459020 WI Primary

Addresses

Primary practice location

442 N Westhill Blvd Ste a
Appleton, WI 54914-5830

Mailing address

442 N Westhill Blvd Ste a
Appleton, WI 54914-5830
Phone (920) 751-8666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120824000125 WI Practitioner - Ophthalmology 1557485992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Saint Louis University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Wisconsin Retina Associates SCGroup PAC ID 8224029707, 7 clinicians

Practice addresses (Care Compare)

442 N Westhill Blvd
Suite a
Appleton, WI 54914-5831
Phone (920) 751-8666

480 Pilgrim Way
Suite 1305
Green Bay, WI 54304-5279
Phone (920) 592-0111

515 S Washburn St
Suite 101a
Oshkosh, WI 54904-7951
Phone (920) 232-8060

723 Park Ridge LN
Suite 10
North Fond Du Lac, WI 54937-1385
Phone (920) 322-8688

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48790COMDOphthalmology Physician
57459020WIMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Wisconsin Retina Associates SC Retina Specialist CurrentSince Aug 20, 2012 Accepting new patients

Locations

442 N Westhill Blvd
Ste A
Appleton, WI 54914
Phone (920) 751-8666

1087 W Mason St
Green Bay, WI 54303
Phone (920) 499-3102

200 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 358-1223

200 Theda Clark Medical Plz
Ste 110
Neenah, WI 54956
Phone (920) 751-8666

515 S Washburn St
Ste 101A
Oshkosh, WI 54904
Phone (920) 232-8060

Interoperability endpoints

  • Direct secure messaging: bernst@newretinamd.intellechartdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1518162247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 N WESTHILL BLVD STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145830",
            "telephone_number": "920-751-8666",
            "fax_number": "920-751-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N WESTHILL BLVD STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145830",
            "telephone_number": "920-751-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "48790",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "WI",
            "license": "57459020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.