MARC L BENTON M.D.
NPI 1003817156
Internal Medicine - Pulmonary Disease in Madison, NJ

Q: What is Marc Benton's NPI number?

The NPI number for Marc Benton is 1003817156. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Q: What is Marc Benton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: Is Marc Benton enrolled in Medicare?

No. Marc Benton has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Marc Benton was last updated on November 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since August 10, 2005Opted out of Medicare · through Jan 1, 2028

300 MADISON AVE, SUITE 201, MADISON, NJ 07940(973) 822-2772(973) 822-2773 Get Directions Write a Review

NPPES record last updated: November 20, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Marc L Benton M.d. NPPES

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

MARC L BENTON M.D. (NPI 1003817156) is an individual pulmonary disease provider in Madison, New Jersey, licensed in New Jersey (25MA05147800) and active in the NPI registry since August 2005. He has opted out of Medicare through January 1, 2028 and remains eligible to order and refer and is a graduate of Other (1982).

NPPES Registry Identity

NPI1003817156

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameMARC L BENTONCredential: M.D.

Location Address300 MADISON AVE, SUITE 201Madison, NJ 07940

Mailing Address300 Madison Ave, Suite 201Madison, NJ 07940 · (973) 822-2772 · Fax (973) 822-2773

Phone(973) 822-2772

Fax(973) 822-2773

Sole ProprietorYes

Medical School CMSOtherGraduated 1982

Enumeration DateAugust 10, 2005

Last NPPES UpdateNovember 20, 2019

✔ NPI 1003817156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NJ · 25MA05147800

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 25MA05147800 (NJ)

300 MADISON AVE, Madison, NJ 07940

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Other Identifiers 8

Other222233003NJ · Horizon Blue Cross

OtherES253NJ · Oxford

Other6752022NJ · Aetna Hmo

Other67F351NJ · Empire

Other4109289NJ · Aetna Ins.

Other222233003004NJ · Cigna

Other121696NJ · Chn Ins.

Other263944134NJ · Horizon Blue Cross Blue Shield

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Marc L Benton M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2026 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2026

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Areas of Expertise CMS Part B claims 2

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.

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.

112 services97 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

36 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07940 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

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

Referred Medical Equipment & Supplies CMS DME claims 23

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

Tubing with integrated heating element for use with positive airway pressure device A4604