Individual provider Active NPI

Benjamin Ray Wilson, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lexington, KY
National Provider Identifier
1871900068
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
53472 Issued in KY
Practice address
740 S Limestone
Room K403
Lexington, KY 40536-0001
Phone
(859) 218-3044
NPI assigned
Jul 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R3658 KY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 53472 KY Primary

Addresses

Primary practice location

740 S Limestone
Room K403
Lexington, KY 40536-0001

Mailing address

740 S Limestone
Room K403
Lexington, KY 40536-0001

Other practice location 1

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504
Phone (859) 218-3064

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
I20200616003592 KY Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 7113232190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

2195 Harrodsburg Rd
Lexington, KY 40504-3504
Phone (859) 257-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Nov 25, 2020 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Shriners Hospitals for Children CurrentSince Nov 25, 2020 Accepting new patients
Shriners Hospitals for Children Orthopaedic Surgery Past Accepting new patients

Locations

2195 Harrodsburg Rd
Ste 125
Lexington, KY 40504
Phone (859) 257-4732

2195 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 323-2232

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

215 Radio Dr
Ste 100
Woodbury, MN 55125
Phone (612) 596-6100

Interoperability endpoints

  • Direct secure messaging: bwilson63782@ukhcdirect.org

Organizations & group practices 5

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": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1871900068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "ROOM K403",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "ROOM K403",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-218-3044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043504",
            "country_code": "US",
            "telephone_number": "859-218-3064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BENJAMIN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-19",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "R3658",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "KY",
            "license": "53472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.