BENJAMIN DENNIS MICHAEL PMHNP
NPI 1194523423
Nurse Practitioner - Psychiatric/Mental Health in Decatur, AL
NPI Status: Active since March 04, 2025
Contact Information
1615 KATHY LN SW STE 102
DECATUR, AL
ZIP 35603
Phone: (256) 701-5651
Fax: (256) 429-9411
- Individual
- Male
- Nurse Practitioner
- Psychiatric/Mental Health
- Accepts Insurance
- PECOS Enrolled
About BENJAMIN MICHAEL
This page provides the complete NPI Profile along with additional information for Benjamin Michael, a provider established in Decatur, Alabama with a medical specialization in Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1194523423 assigned on March 2025. The practitioner's primary taxonomy code is 363LP0808X with license number 1-151012 (AL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1194523423
- Provider Name
- BENJAMIN DENNIS MICHAEL PMHNP
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1615 KATHY LN SW STE 102 DECATUR, AL 35603
- Location Phone
- (256) 701-5651
- Location Fax
- (256) 429-9411
- Mailing Address
- 600 SUN TEMPLE DR MADISON, AL 35758
- Mailing Phone
- (256) 975-4291
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-04-2025
- Last Update Date
- 03-04-2025
- Code Navigator
A nurse practitioner (NP) like Benjamin Michael 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.
Location Map
Secondary Locations
- 1985 Al Highway 157 Ste B
Cullman, AL 35058
(256) 701-5651
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 1-151012
- License State
- AL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Clarity Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Saver Silver EPO - EPO
- Blue Standardized Silver EPO - EPO
- Blue Standardized Statewide Silver EPO - EPO
- Blue Statewide Silver EPO - EPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple Chronic Care CKM - EPO
- Gold Classic Standard - EPO
- Gold Simple - EPO
- Silver Classic Standard - EPO
- Silver Simple - EPO
- Silver Simple Chronic Care CKM - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Benjamin Michael 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 35603 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.9
- Minimum New Patient Price $52.65
- Maximum New Patient Price $161.63
- Average New Patient Copayment $20.47
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.4
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.72
- Minimum Established Patient Price $16.56
- Maximum Established Patient Price $131.65
- Average Established Patient Copayment $23.43
- Minimum Established Patient Copayment $4.14
- Maximum Established Patient Copayment $32.91
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1194523423, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 11 providers are registered at the same or a nearby location.
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
DECATUR, AL 35603
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194523423, enumerated as an "individual" on March 04, 2025.
The provider is located at 1615 KATHY LN SW STE 102 DECATUR, AL 35603 and the phone number is (256) 701-5651.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
The provider might be accepting Accepts: Ambetter from Magnolia Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.
