MR. BENJAMIN DURHAM PA-C NPI 1003006115

Physician Assistant in Thomaston, GA

NPI 1003006115 Individual Male Years of Experience 15 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About BENJAMIN DURHAM

Benjamin Durham is a primary care provider established in Thomaston, Georgia and his medical specialization is physician assistant with more than 15 years of experience. He graduated from Medical College Of Georgia School Of Medicine in 2007. The NPI number of Benjamin Durham is 1003006115 and was assigned on July 2007. The practitioner's primary taxonomy code is 363A00000X with license number 005084 (GA). The provider is registered as an individual and his NPI record was last updated one year ago.

A primary care provider (PCP) like Mr. Benjamin Durham Pa-c sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Benjamin Durham is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Benjamin Durham is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Jack Hughston Memorial Hospital and Upson Regional Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: chronic care and preventative care management for empaneled patients, documentation of current medications in the medical record, e-prescribing exclusion, health information exchange exclusion, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, onc direct review attestation, onc-acb surveillance attestation (optional), patient-specific education, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: tobacco use: screening and cessation intervention, preventive care and screening: tobacco use: screening and cessation intervention, provide patient access, secure messaging, security risk analysis, use of decision support and standardized treatment protocols and view, download, or transmit (vdt). The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1003006115

Provider NameMR. BENJAMIN DURHAM PA-C
Provider Location Address522 N CENTER ST THOMASTON, GA 30286
Provider Mailing AddressPO BOX 370 FORTSON, GA 31808
GenderMale
NPI Entity TypeIndividual
Medical School NameMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-26-2007
Last Update Date11-20-2020


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.005084
License StateGA
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

MR. BENJAMIN DURHAM PA-C
522 N CENTER ST
THOMASTON, GA
ZIP 30286
Phone: (706) 646-4371
Fax: (706) 646-4372

Get Directions


Mailing Address

MR. BENJAMIN DURHAM PA-C
PO BOX 370
FORTSON, GA
ZIP 31808
Phone:
Fax: (706) 494-3008



Secondary Locations

2300 Manchester Expy # A Suite 101-A
Columbus, GA 31904
(706) 322-2462
100 N Macon St
Macon, GA 31210
(478) 200-6970

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID9335223908
PECOS Enrollment IDI20080221000313, I20110427000583
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 128Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • 28Repair of knee joint (HCPCS:27447)
  • 21Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Rate Number of Patients
Documentation of Current Medications in the Medical Record 30% 454
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Medication Reconciliation 86% 72
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 79% 434
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 19% 355
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 85% 33
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 97% 33
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access 99% 434
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 1% 434
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
View, Download, or Transmit (VDT) 25% 434
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Benjamin Durham is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
JACK HUGHSTON MEMORIAL HOSPITAL4401 RIVER CHASE DRIVE
PHENIX CITY, AL 36867
(334) 732-3000Acute Care Hospitals10168
UPSON REGIONAL MEDICAL CENTER801 W GORDON STREET
THOMASTON, GA 30286
(706) 647-8111Acute Care Hospitals110002

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902374226 MORGAN MARIE DACOSTA PT, DPT
Individual
Physical Therapist522 N CENTER ST
THOMASTON, GA 30286
(706) 646-4371
1093237323 KATHRYN GIBBS DPT
Individual
Physical Therapist522 N CENTER ST
THOMASTON, GA 30286
(706) 646-4371
1962763441DR. EDGAR JOSEPH DOLLAR II D.O.
Individual
Family Medicine (Sports Medicine)522 N CENTER ST
THOMASTON, GA 30286
(706) 646-4371

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.