NPIMap

Individual provider Active NPI

Benjamin J Phelan, PAC

  • Physician Assistant
  • Stevens Point, WI
National Provider Identifier
1750532917
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3392-23 Issued in WI
Practice address
500 Vincent St
Stevens Point, WI 54481
Phone
(715) 344-0701
NPI assigned
Oct 7, 2008
Last updated
May 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3392-23 WI Primary

Addresses

Primary practice location

500 Vincent St
Stevens Point, WI 54481

Mailing address

500 Vincent St
Stevens Point, WI 54481-1842
Phone (715) 344-0701

Other practice location 1

824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 342-7500

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
I20141003000594 WI Practitioner - Physician Assistant 2163642604 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3901 Stewart Ave
Wausau, WI 54401-3948
Phone (715) 907-0900

500 Vincent St
Stevens Point, WI 54481-1842
Phone (715) 344-0701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.57 of 100Reported as group
Quality
77.2
Promoting interoperability
59
Improvement activities
40
Cost
88.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3392-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 20, 2020 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 1, 2014 Accepting new patients
Orthopaedic Centers of Wisconsin S C CurrentSince Aug 27, 2018 Accepting new patients
Orthopaedic Centers of Wisconsin S C CurrentSince Aug 27, 2018 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 20, 2020 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

500 Vincent St
Stevens Point, WI 54481
Phone (715) 341-7920

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

3901 Stewart Ave
Wausau, WI 54401
Phone (715) 907-0900

Interoperability endpoints

  • Direct secure messaging: benjamin.phelan@spo.directbygreenway.com

Organizations & group practices 11

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1750532917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VINCENT ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811842",
            "telephone_number": "715-344-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINCENT ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-344-0701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544813112",
            "country_code": "US",
            "telephone_number": "715-342-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3392-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.