Individual provider Active NPI

William John Van Beneden, D.O.

  • Otolaryngology Physician
  • Ashland, KY
National Provider Identifier
1518172014
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
03158 Issued in KY
Practice address
613 23Rd St Ste 420
Ashland, KY 41101-2885
Phone
(606) 325-8561
Fax
(606) 325-3591
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 03158 KY Primary

Addresses

Primary practice location

613 23Rd St Ste 420
Ashland, KY 41101-2885

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other practice location 1

100 Bellefonte Dr
Grayson, KY 41143-1820
Phone (606) 475-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20090728000217 KY Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 5799838561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Ohio University, College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

613 23Rd St
Suite 420
Ashland, KY 41101-2885
Phone (606) 324-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03158KYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Apr 1, 2016 Accepting new patients
Kings Daughters Medical Specialties Inc Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441

Interoperability endpoints

  • Direct secure messaging: wvanbeneden55733@direct.kdhealth.us

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.

Hospital & facility affiliations 1

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1518172014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE 420",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012885",
            "telephone_number": "606-325-8561",
            "fax_number": "606-325-3591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bellefonte Dr",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "KY",
            "postal_code": "411431820",
            "country_code": "US",
            "telephone_number": "606-475-5505",
            "fax_number": "606-475-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BENEDEN",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "03158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.