Benjamin M Mack, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

45040 Issued in KY

Practice address

3535 Southern Blvd
Kettering, OH 45429-1221

Phone

(937) 384-6800

Fax

(937) 384-6839

NPI assigned

Aug 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, WV, OH3 enrollments

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 3

Specialty

Emergency Medicine

Education

Wright State University Boonshoft School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Emergency Physicians Ohio LLCGroup PAC ID 8527233261, 8 clinicians

Allied West Virginia Emergency Physicians PLLCGroup PAC ID 8325326648, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valley Emergency Physicians Ohio LLC

  • Emergency Medicine Physician
  • Ironton, OH
  • NPI 1528342961
  Medicare reassignment Care Compare group NPD
• Allied West Virginia Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1487109104
  Medicare reassignment Care Compare group NPD
• Racine Observation Medical Group, PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1588196851
  Medicare reassignment NPD
• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353

  KY

  Medicare reassignment

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

• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1649402249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "BENJAMIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "45040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Ann Lyman, MD
• John Lynch III, M.D.
• M Wassef Dabbas MD
• M&D Bright Inc.
• Laura Renee Maag, CNP
• Nahid Madadinia, PHARMD
• Kellie Maertz, PA-C
• Deborah Magnotta, C.N.P.
• Ashish Mahajan, M.D.
• Marjorie Ann Mahle, RN, CNP

• Emergency Medicine Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.