DR. BENJAMIN P NICHOLSON M.D., M.A.
NPI 1003016916
Ophthalmology - Retina Specialist in Saint Joseph, MI

Q: What is Benjamin Nicholson's NPI number?

The NPI number for Benjamin Nicholson is 1003016916. It was assigned to this individual provider in the NPPES registry on July 19, 2007.

Q: What is Benjamin Nicholson's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Active since July 19, 2007PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

2848 NILES RD, SAINT JOSEPH, MI 49085(269) 428-3300(269) 428-5005 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Benjamin P Nicholson M.d., M.a. NPPES

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

DR. BENJAMIN P NICHOLSON M.D., M.A. (NPI 1003016916) is an individual retina specialist in Saint Joseph, Michigan, licensed in Michigan (4301106941) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Lakeland Hospital, St Joseph, and is a graduate of Saint Louis University School Of Medicine (2007).

NPPES Registry Identity

NPI1003016916

Entity TypeIndividualMale

Primary Taxonomy207WX0107X

Provider Legal NameDR. BENJAMIN P NICHOLSONCredential: M.D., M.A.

Location Address2848 NILES RDSaint Joseph, MI 49085-3352

Mailing Address2848 Niles RdSaint Joseph, MI 49085-3352 · (269) 428-3300 · Fax (269) 428-5005

Phone(269) 428-3300

Fax(269) 428-5005

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2007

Enumeration DateJuly 19, 2007

Last NPPES UpdateApril 26, 2023

NPPES CertifiedApril 26, 2023

✔ NPI 1003016916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

License✔ Licensed in MI · 4301106941

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X · License 4301106941 (MI)

2848 NILES RD, Saint Joseph, MI 49085

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Dr. Benjamin P Nicholson M.d., M.a. 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 ID1759523723

PECOS Enrollment IDI20150603001565, I20171110001928

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 15

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, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

21,360 services90 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

1,811 services468 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

1,315 services679 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

1,120 services179 patients

Unclassified biologics J3590

Unclassified biologics are a type of treatment derived from living organisms. They can include a wide range of substances, such as vaccines, blood components, or genes, used to prevent or treat diseases. Each is specifically designed to interact with the body's natural defenses to promote healing.

617 services203 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

477 services387 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

363 services290 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.

303 services214 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

52 services52 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

37 services37 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

27 services27 patients

Destruction of growth of retina using a laser 67210

This procedure involves using a precise laser to target and remove abnormal growths on the retina, the thin layer at the back of the eye. It's a safe and effective way to protect your vision and prevent further eye damage.

18 services15 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

17 services13 patients

Photocoagulation treatment to prevent detachment of retina 67145

Photocoagulation is a procedure used to treat retinal disorders. A special laser is directed at the retina to create small burns. These burns form scar tissue which helps to secure the retina to the eye's wall, preventing detachment and preserving vision.

13 services12 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Lakeland Hospital, St Joseph

Acute Care Hospitals · St Joseph, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230021

Location1234 Napier AvenueSt Joseph, MI 49085 · Berrien County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49085 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.54

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

48%136 patients2/55-star benchmark: 100%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

100%79 patients5/55-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.

Other Providers at the Same Location NPPES 16

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

GREAT LAKES SURGERY CENTER LLC

Clinic/Center (Ambulatory Surgical)

2848 NILES RD, SUITE B
SAINT JOSEPH, MI 49085

Berrien County (269) 428-3304

NICHOLAS GEORGE KEINATH OD

Optometrist