Benjamin Head, MD
Individual provider Active NPI Family Medicine Physician · Cordova, AK
NPI 1962898080 · NPPES record last updated Sep 1, 2021
Key facts
- NPI
- 1962898080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 139968 (AK)
- Practice address
- 705 2ND Street
Cordova, AK 99574-2290 - Phone
- (907) 424-3622
- Fax
- (907) 424-3275
- NPI assigned
- Apr 15, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 14
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cordova Community Medical Center
Native Village of Eyak
Practice addresses (Care Compare)
602 Chase Ave
Cordova, AK 99574-0559
Phone (907) 424-8000
705 2ND St
Native Village of Eyak Ilanka Com
Cordova, AK 99574-2290
Phone (907) 424-3622
Hospital & facility affiliations
- Cordova Community Medical Center
- Alaska Native Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AK
- 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 |
|---|---|---|---|---|
| I20210525000299 | TX | Practitioner - Family Practice | 0042515702 | Reassigns benefits to 1 organization |
| I20221118001759 | AK | Practitioner - Family Practice | 0042515702 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cordova Community Medical Center | Current |
Accepting new patients | |
| Native Village of Eyak | Current |
Accepting new patients | |
| Native Village of Eyak | Current |
Accepting new patients |
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/cordova-527880fe
- bhead@direct.eyak-nsn.gov
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 139968 | AK | Yes |
Addresses
Primary practice location
705 2ND Street
Cordova, AK 99574-2290
Mailing address
705 2ND Street
Cordova, AK 99574-2290
Phone (907) 424-3622
Other practice location 1
711 Onyx St
Kemmerer, WY 83101
Phone (307) 877-4401
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | BHEAD@direct.eyak-nsn.gov | Direct |
Other providers in Cordova, AK
- Rebekah Zarling Cushing
- Erin Frohnapfel
- Alyce L Garrity
- Steve T Goniotakis
- Melissa Guy
- Carly Heidenreich
- Laura Ann Henneker
- Joan Catherine Herschleb
- Aaron Jeffrey Holm
- Brian Iutzi
All providers in Cordova, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2021. 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.