Benedict E Aimua, MD
Individual provider Active NPI Internal Medicine Physician · Johnson City, TN
NPI 1962674424 · NPPES record last updated Jul 16, 2015
Key facts
- NPI
- 1962674424
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 43736 (TN)
- Practice address
- 119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998 - Phone
- (423) 282-1480
- Fax
- (423) 928-1353
- NPI assigned
- Mar 25, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeastern Physician Services PC
Practice addresses (Care Compare)
1201 Bishop St
Union City, TN 38261-5403
Phone (731) 885-2410
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
Hospital & facility affiliations
- Ballad Health Homecare
- Ballad Health Hospice
- Johnson City Medical Center
- Sycamore Shoals Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- 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 |
|---|---|---|---|---|
| I20080731000603 | TN | Practitioner - Internal Medicine | 9133293616 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | TN | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Internal Medicine | Current |
Accepting new patients |
| Mountain States Health Alliance | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000
880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | PENDING | TN | |
| Internal Medicine Physician | 207R00000X | 43736 | TN | Yes |
Addresses
Primary practice location
119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Mailing address
119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Phone (423) 282-1480
Other providers in Johnson City, TN
- Ahp Home Health, LLC
- Alan J Aiken
- Marc A Aiken
- William Worden Aiken III
- Vanessa L Ailey
- Faith A Aimua
- Pavel Aksionav
- Rania A Al Asmar
- Amani Al Housseiny
- Ahmad Samih Al Tamari
All providers in Johnson City, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2015. 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.