MR. BENJAMIN DANIEL MALCOLM FNP NPI 1013083229
Nurse Practitioner - Family in Centerville, OH

About MR. BENJAMIN DANIEL MALCOLM FNP

Benjamin Malcolm is a provider established in Centerville, Ohio and his medical specialization is Nurse Practitioner with a focus in family with more than 9 years of experience. The NPI number of Benjamin Malcolm is 1013083229 and was assigned on November 2006. The practitioner's primary taxonomy code is 363LF0000X with license number APRN.CNP.15883 (OH). The provider is registered as an individual and his NPI record was last updated August 2022.

NPI
1013083229
Provider NameMR. BENJAMIN DANIEL MALCOLM FNP
Location Address1095 S MAIN ST CENTERVILLE, OH 45458
Location Phone(937) 439-8622
Mailing Address2620 ELM HILL PIKE NASHVILLE, TN 37214
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2014
Is Sole Proprietor?No
Enumeration Date11-28-2006
Last Update Date08-12-2022

A nurse practitioner (NP) like Mr. Benjamin Daniel Malcolm Fnp is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.Benjamin Malcolm is enrolled in PECOS and is eligible to order or refer health care 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 Malcolm 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 74.5, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.93 for a new patient copayment and $25.3 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code363LF0000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.APRN.CNP.15883
License StateOH

Business Address

MR. BENJAMIN DANIEL MALCOLM FNP
1095 S MAIN ST
CENTERVILLE, OH
ZIP 45458
Phone: (937) 439-8622

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Mailing Address

MR. BENJAMIN DANIEL MALCOLM FNP
2620 ELM HILL PIKE
NASHVILLE, TN
ZIP 37214
Phone: (615) 425-4200


Location Map

PECOS Enrollment and Medicare Participation Status

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.

Registered in PECOS? Yes
PECOS PAC ID6800013293
PECOS Enrollment IDI20140807002401
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

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 45458 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $87.72
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $21.93
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $101.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $25.3

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 86.7
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 18
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% 98
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 74.5
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013083229
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
202308624
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 6 + 2 + 4 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1013083229 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1427235043DR. JOHN ADAM WEYRAUCH V PHARM D
Individual
Pharmacist1095 S MAIN ST KROGER PHARMACY
CENTERVILLE, OH 45458
(937) 439-6420
1073547774KROGER LIMITED PARTNERSHIP I
Organization
Pharmacy (Community/Retail Pharmacy)1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 439-6420
1184257834 KHALEEL AHMED
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 439-6420
1588276166 PATRICK SABOL
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 439-6420
1962738278MS. SARAH KRISTINE BENNETT NP-C
Individual
Nurse Practitioner (Family)1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 435-8210
1265023782MRS. REGINA JOY TATMAN OH APRN 026633
Individual
Nurse Practitioner (Family)1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 435-8210
1558099333DR. MARY CARLEEN SPROW PHARMD
Individual
Pharmacist1095 S MAIN ST
CENTERVILLE, OH 45458
(937) 439-6420

Frequently Asked Questions

What is Mr. Benjamin Malcolm FNP NPI number?

The NPI number assigned to Mr. Benjamin Malcolm FNP is 1013083229, registered as an "individual" on November 28, 2006

Where is Mr. Benjamin Malcolm FNP located?

The provider is located at 1095 S Main St Centerville, Oh 45458 and the phone number is (937) 439-8622

Which is Mr. Benjamin Malcolm FNP specialty?

The provider's speciality is Nurse Practitioner with a focus in Family

How many years of experience does Mr. Benjamin Malcolm FNP have?

The provider has more than 9 years of experience.

Is Mr. Benjamin Malcolm FNP registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.

How much is a visit to Mr. Benjamin Malcolm FNP?

Medicare beneficiaries should expect a typical cost of $87.72 with an average copayment of $21.93 for new patient appointments. Established patients should expect a typical charge of $101.2 and an average copayment of 25.3. Please review your insurance plan or contact the provider directly to determine your specific costs.

How do I update my NPI information?

The NPI record of Mr. Benjamin Malcolm FNP was last updated on November 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]