Individual provider Active NPI

Ben B Mahan, M.D.

  • Ophthalmology Physician
  • Tullahoma, TN
National Provider Identifier
1881690311
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
TN18870 Issued in TN
Practice address
926 N Jackson St
Tullahoma, TN 37388-2300
Phone
(931) 393-6004
Fax
(931) 393-4795
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X TN18870 TN
Ophthalmology Physician 207W00000X TN18870 TN Primary

Addresses

Primary practice location

926 N Jackson St
Tullahoma, TN 37388-2300

Mailing address

926 N Jackson St
Tullahoma, TN 37388-2300
Phone (931) 393-6004

Other identifiers 2

IdentifierTypeStateIssuer
3074482OtherTNBLUE CROSS BLUE SHIELD
3039979MedicaidTN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Direct@MahanRidleyEyeAssociatesTullahomaTN.CompulinkDirect.com Direct
Direct Messaging Address Direct@MahanRidleyEyeAssociatesTullahomaTN.CompulinkDirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050131000826 TN Practitioner - OphthalmologyPractitioner - Other (Physician) 3870543499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Oklahoma College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye M D Ophthalmology PLLCGroup PAC ID 1052460060, 2 clinicians

Practice addresses (Care Compare)

926 N Jackson St
Tullahoma, TN 37388-2300
Phone (931) 393-6004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as group
Quality
94.69
Improvement activities
40
Cost
70.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery125
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TN18870TNMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye M D Ophthalmology PLLC Ophthalmology CurrentSince Jan 1, 1998 Accepting new patients
Eye Associates Optical, LLC. CurrentSince Jul 1, 2010 Accepting new patients

Locations

926 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-6004

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.

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1881690311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882300",
            "telephone_number": "931-393-6004",
            "fax_number": "931-393-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882300",
            "telephone_number": "931-393-6004",
            "fax_number": "931-393-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "BEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "TN",
            "license": "TN18870",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "TN18870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3074482",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3039979",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@MahanRidleyEyeAssociatesTullahomaTN.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "926 N Jackson St",
            "city": "Tullahoma",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373882300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@MahanRidleyEyeAssociatesTullahomaTN.CompulinkDirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "926 N Jackson St",
            "city": "Tullahoma",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373882300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.