Active NPI
Benjamin Hodges, PA-C
- Physician Assistant
- Fort Atkinson, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5474-23
- Practice address
- 1504 Madison Ave
Fort Atkinson, WI 53538-3100 - Phone
- (920) 563-7888
- NPI assigned
- Aug 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.006721 | IL | |
| Medical Physician Assistant | 363AM0700X | 085.006721 | IL | |
| Surgical Physician Assistant | 363AS0400X | 085.006721 | IL | |
| Physician Assistant | 363A00000X | 5474-23 | WI | Primary |
Addresses
Primary practice location
1504 Madison Ave
Fort Atkinson, WI 53538-3100
Mailing address
PO Box 249
Fort Atkinson, WI 53538-0249
Phone (920) 563-4466
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1504 Madison Ave
Fort Atkinson, WI 53538-3100
Phone (920) 563-7888
1520 Madison Ave
Fort Atkinson, WI 53538-3100
Phone (920) 563-5500
611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000
611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-6596
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.006721 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Healthcare, Inc. | Current | Accepting new patients | |
| Fort Healthcare Inc | Past | Accepting new patients |
Locations
1504 Madison Ave
Fort Atkinson, WI 53538
Phone (920) 563-7888
611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667
Interoperability endpoints
- benjamin.hodges@direct.forthc.com
Organizations & group practices 2
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.
-
- Otolaryngology Physician
- Fort Atkinson, WI
- NPI 1417993361
-
- General Acute Care Hospital
- Fort Atkinson, WI
- NPI 1811916281
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Atkinson, WI
- NPI 1811916281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1790266971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 249",
"city": "FORT ATKINSON",
"state": "WI",
"postal_code": "535380249",
"telephone_number": "920-563-4466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 MADISON AVE",
"city": "FORT ATKINSON",
"state": "WI",
"postal_code": "535383100",
"telephone_number": "920-563-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGES",
"first_name": "BENJAMIN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-24",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.006721",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085.006721",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "085.006721",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "5474-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Atkinson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.