Benjamin Holler
Individual provider Active NPI Family Medicine Physician · Glenpool, OK
NPI 1902335698 · NPPES record last updated Apr 15, 2024
Key facts
- NPI
- 1902335698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 38874 (OK)
- Practice address
- 12142 S Yukon Avenue
Glenpool, OK 74033-6621 - Phone
- (918) 935-3636
- Fax
- (918) 777-9019
- NPI assigned
- Jun 7, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Texas a & M University System, HSC, College of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Transformation Health PLLC
Kisatchie Emergency Group LLC
Calcasieu Cameron Emergency Physician Group LLC
Practice addresses (Care Compare)
1008 W Taft Ave
Sapulpa, OK 74066-8720
Phone (918) 935-3636
1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (337) 239-5278
701 E Cypress St Emergency Dept
Sulphur, LA 70663-5053
Phone (337) 527-7034
Hospital & facility affiliations
- Jackson County Regional Health Center
- Lake Charles Memorial Hospital
- Byrd Regional Hospital
- West Calcasieu Cameron Hospital
- Opelousas General Health System
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.62 of 100
- Quality
- 70.88
- Improvement activities
- 40
- Cost
- 75.82
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (7 enrollments) in KY, FL, TX, LA, OK, IA, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180914000191 | KY | Practitioner - Family Practice | 1658621529 | Reassigns benefits to 1 organization |
| I20230111000798 | FL | Practitioner - Family Practice | 1658621529 | |
| I20230509001894 | TX | Practitioner - Family Practice | 1658621529 | Reassigns benefits to 2 organizations |
| I20240401000349 | LA | Practitioner - Emergency Medicine | 1658621529 | Reassigns benefits to 7 organizations |
| I20240422002778 | OK | Practitioner - Family Practice | 1658621529 | Reassigns benefits to 1 organization |
| I20241126000969 | IA | Practitioner - Emergency Medicine | 1658621529 | Reassigns benefits to 3 organizations |
| I20241220000858 | PA | Practitioner - Emergency Medicine | 1658621529 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Emergency Physician Partners LLC | Emergency Medicine | Current |
Accepting new patients |
| Genesis Health System | Current |
Accepting new patients | |
| University of Pittsburgh Physicians | Current | Accepting new patients | |
| Professional Emergency Medicine Management -- Lake Charles LLC | Emergency Medicine | Current |
Accepting new patients |
| Transformation Health PLLC | Family Medicine | Current |
Accepting new patients |
| Jackson County Public Hospital | Current | Accepting new patients | |
| University of Pittsburgh Physicians | Emergency Medicine | Current |
Accepting new patients |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
| Northern Louisiana Emergency Physicians LLP | Emergency Medicine | Current |
Accepting new patients |
| Travis County Emergency Physicians PA | Emergency Medicine | Current |
Accepting new patients |
| University of Pittsburgh Physicians | Current |
Accepting new patients | |
| Northern Louisiana Emergency Physicians, LLP | Emergency Medicine | Current |
Accepting new patients |
| Kisatchie Emergency Group, LLC | Emergency Medicine | Current |
Accepting new patients |
| Genesis Health System | Family Medicine | Past | Accepting new patients |
Locations
1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191
1118 11th St
De Witt, IA 52742
Phone (563) 242-7522
601 Hospital Dr
Maquoketa, IA 52060
Phone (563) 652-2474
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100
900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900
1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000
1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278
3983 I 49 S Service Rd
Opelousas, LA 70570
Phone (337) 407-4512
401 E Vaughn Ave
Ruston, LA 71270
Phone (318) 254-2100
1900 Main St
Sheridan, LA 70438
Phone (985) 839-4431
12142 S Yukon Ave
Glenpool, OK 74033
Phone (918) 417-7773
1008 W Taft Ave
Sapulpa, OK 74066
Phone (918) 347-8090
2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864
200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553
7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305
6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000
Interoperability endpoints
- bholler65146@bhkydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 52911 | KY | |
| Emergency Medicine Physician | 207P00000X | R4433 | KY | |
| Family Medicine Physician | 207Q00000X | 38874 | OK | Yes |
Addresses
Primary practice location
12142 S Yukon Avenue
Glenpool, OK 74033-6621
Mailing address
12142 S Yukon Avenue
Glenpool, OK 74033-6621
Phone (918) 935-3636
Other providers in Glenpool, OK
- Colby Greuel
- Caden Samuel Hale
- Morgan Hansen
- Brenda Hayman-Hensley
- Daniel Calvin Henshaw
- Increasing Tranquility LLC
- Insight Eyecare PLLC
- Integrated Renegade, LLC
- Jamie D Jarvis
- Keri Ann Jenkins
All providers in Glenpool, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.