MR. BENJAMIN DURHAM PA-C
NPI 1003006115
Physician Assistant - Surgical in Thomaston, GA

Active since July 26, 2007PECOS EnrolledAccepts Medicare Assignment
60.39/100
CMS Quality Rating
522 N CENTER ST, THOMASTON, GA 30286(706) 646-4371(706) 646-4372 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2025, Nov 20, 2020, Jun 4, 2020 (3 updates tracked since 2020).

About Mr. Benjamin Durham Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BENJAMIN DURHAM PA-C (NPI 1003006115) is an individual surgical provider in Thomaston, Georgia, licensed in Georgia (5084) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Upson Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003006115
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. BENJAMIN DURHAMCredential: PA-C
Location Address522 N CENTER STThomaston, GA 30286-3695
Mailing AddressPo Box 370Fortson, GA 31808-0370 · Fax (706) 494-3008
Fax(706) 646-4372
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2007
Enumeration DateJuly 26, 2007
Last NPPES UpdateAugust 6, 20253 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
NPI 1003006115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Licenses Licensed in GA · 5084 Licensed in AL · PA.749
Also ListedPhysician AssistantTaxonomy 363A00000X · License 005084 (GA)
522 N CENTER ST, Thomaston, GA 30286

Secondary Practice Locations 2

Location 12300 Manchester Expy # A, Suite 101-AColumbus, GA 31904-6802 · Phone (706) 322-2462 · Fax (706) 320-3227
Location 2100 N Macon StMacon, GA 31210-6563 · Phone (478) 200-6970 · Fax (478) 200-6970

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Benjamin Durham Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335223908
PECOS Enrollment IDI20080221000313, I20110427000583
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
2,058 services226 patients
Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325
Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.
944 services12 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
816 services334 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
308 services163 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
256 services163 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
123 services113 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Upson Regional Medical Center

Acute Care Hospitals · Thomaston, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110002
Location801 W Gordon StreetThomaston, GA 30286 · Upson County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Piedmont Columbus Regional Northside

Acute Care Hospitals · Columbus, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110200
Location100 Frist CourtColumbus, GA 31909 · Muscogee County

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

60.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality32.35
Promoting Interoperability92
Improvement Activities40

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
16%426 patients1/55-star benchmark: 87%
Controlling High Blood Pressure
39%41 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
27%4,421 patients1/55-star benchmark: 100%
e-Prescribing
98%250 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
15%1,631 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
5%4,169 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 1% · 1,357 patients
1%1,357 patients
Provide Patients Electronic Access to Their Health Information
75%722 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
71%76 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 940 patients
Patients totalRate: 1% · 940 patients
1%940 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier15 claims15 services$218.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
522 N CENTER ST
THOMASTON, GA 30286
Physical Therapist
522 N CENTER ST
THOMASTON, GA 30286
Family Medicine (Sports Medicine)
522 N CENTER ST
THOMASTON, GA 30286

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Durham's NPI number?

The NPI number for Benjamin Durham is 1003006115. It was assigned to this individual provider in the NPPES registry on July 26, 2007.

Where is Benjamin Durham located?

Benjamin Durham practices at 522 N Center St, Thomaston, GA 30286. The listed phone number is (706) 646-4371.

What is Benjamin Durham's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Benjamin Durham enrolled in Medicare?

Yes. Benjamin Durham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Benjamin Durham accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 2 other insurers list Benjamin Durham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Benjamin Durham affiliated with any hospitals?

According to CMS data, Benjamin Durham is affiliated with Upson Regional Medical Center, Northside Hospital and Piedmont Columbus Regional Northside.

When was this NPI record last updated?

The NPPES record for Benjamin Durham was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.