NPIMap

Individual provider Active NPI

Benjamin D Tanner, MD

  • Surgery Physician
  • Louisville, KY
National Provider Identifier
1649240649
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33097 Issued in KY
Practice address
1000 Dupont Rd
Louisville, KY 40207-4611
Phone
(502) 889-6405
Fax
(502) 899-6407
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33097 KY Primary

Addresses

Primary practice location

1000 Dupont Rd
Louisville, KY 40207-4611

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 9

IdentifierTypeStateIssuer
110964OtherKYSIHO - NHWMS
200518160MedicaidIN
3945283OtherKYCIGNA - NHWMS
50027318OtherKYPASSPORT - NHWMS
64100811MedicaidKY
000000642238OtherKYANTHEM - NHWMS
000052153COtherKYHUMANA - NHWMS
3764333000OtherKYPASSPORT ADVANTAGE - NHWMS
50006995OtherKYPASSPORT

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/
Direct Messaging Address btanner6143@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050606000478 KY Practitioner - General Surgery 8820031461 Reassigns benefits to 1 organization
I20100308000547 IN Practitioner - General Surgery 8820031461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1000 Dupont Rd
Louisville, KY 40207-4611
Phone (502) 899-6405

10798 Dixie Hwy
Louisville, KY 40272-4302
Phone (502) 588-9490

300 High Point CT
Mount Washington, KY 40047-6560

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33097KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Hospital CurrentSince Sep 3, 2012 Accepting new patients
Riverview Hospital Surgery CurrentSince Sep 3, 2012 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 22, 2014 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 22, 2014 Accepting new patients
Three Rivers Medical Clinics Inc Past Accepting new patients
University Surgical Associates, PSC Surgery Past Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

355 Westfield Rd
Ste 120
Noblesville, IN 46060
Phone (317) 776-0140

865 Westfield Rd
Noblesville, IN 46062
Phone (317) 770-1700

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

1000 DuPont Rd
Louisville, KY 40207
Phone (502) 899-6405

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Organizations & group practices 8

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1649240649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUPONT RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074611",
            "telephone_number": "502-889-6405",
            "fax_number": "502-899-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "33097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - NHWMS",
            "identifier": "110964",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200518160",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - NHWMS",
            "identifier": "3945283",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - NHWMS",
            "identifier": "50027318",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64100811",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NHWMS",
            "identifier": "000000642238",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NHWMS",
            "identifier": "000052153C",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE - NHWMS",
            "identifier": "3764333000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50006995",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "1000 DuPont Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btanner6143@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "1000 DuPont Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.