JERRY A BENHAM MD
NPI 1245290972
Orthopaedic Surgery in Waco, TX

Q: What is Jerry Benham's NPI number?

The NPI number for Jerry Benham is 1245290972. It was assigned to this individual provider in the NPPES registry on March 25, 2006.

Q: What is Jerry Benham's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Benham was last updated on June 25, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 25, 2006PECOS EnrolledAccepts Medicare Assignment

74.33/100

CMS Quality Rating

7125 NEW SANGER AVE, SUITE 516, WACO, TX 76712(254) 752-9638(254) 752-2201 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jerry A Benham Md NPPES

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

JERRY A BENHAM MD (NPI 1245290972) is an individual orthopaedic surgery provider in Waco, Texas, licensed in Texas (H0173) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence, and is a graduate of University Of Texas Medical School At San Antonio (1985).

NPPES Registry Identity

NPI1245290972

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameJERRY A BENHAMCredential: MD

Location Address7125 NEW SANGER AVE, SUITE 516Waco, TX 76712

Mailing Address6600 Fish Pond Rd, Suite 201Waco, TX 76710-2581 · (254) 752-9638 · Fax (254) 752-2201

Phone(254) 752-9638

Fax(254) 752-2201

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 1985

Enumeration DateMarch 25, 2006

Last NPPES UpdateJune 25, 2026

NPPES CertifiedJune 25, 2026

✔ NPI 1245290972 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in TX · H0173

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

7125 NEW SANGER AVE, Waco, TX 76712

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Other Identifiers 1

Medicaid102133902TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Jerry A Benham Md 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 ID6002832706

PECOS Enrollment IDI20110302000731

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 18

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 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.

218 services183 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.

208 services155 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

199 services124 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.

169 services120 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

162 services127 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

144 services92 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.

113 services95 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

90 services71 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

64 services50 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.

62 services62 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.

43 services43 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

40 services38 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

39 services36 patients

Hyaluronan or derivative, monovisc, for intra-articular injection, per dose J7327

Monovisc is a treatment involving an injection of hyaluronan or its derivative into a joint, often the knee. This substance, found naturally in joint fluid, helps lubricate and cushion the joint. The injection can help ease pain, improve mobility, and reduce inflammation caused by arthritis.

28 services19 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

20 services19 patients

X-ray of hip, 1 view 73501

An X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.

20 services19 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

15 services14 patients

X-ray of both hips, 2 views 73521

An X-ray of both hips, 2 views, is an imaging test that uses a small amount of radiation to create detailed pictures of your hip joints. This procedure helps to detect fractures, infections, or other abnormalities in the hip area. Two different angles will be captured for a comprehensive assessment.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension Providence

Acute Care Hospitals · Waco, TX

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450042

Location6901 Medical ParkwayWaco, TX 76712 · Mc Lennan County

Emergency services Birthing friendly

Parkview Regional Hospital

Acute Care Hospitals · Mexia, TX

OwnershipProprietary

CMS Certification Number450400

Location600 South Bonham StreetMexia, TX 76667 · Limestone County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76712 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

74.33/100

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

Scored as part of a group practice

Quality

72.69

Promoting Interoperability

100

Improvement Activities

Cost

41.75

Reported Quality Measures

Advance Care Plan

49%741 patients2/55-star benchmark: 100%

Breast Cancer Screening

53%308 patients3/55-star benchmark: 93%

Cervical Cancer Screening

22%108 patients1/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

72%183 patients4/55-star benchmark: 87%

Colorectal Cancer Screening

55%616 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

65%439 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

23%144 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

31%144 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

89%1,441 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

47%680 patients2/55-star benchmark: 100%

Functional Status Assessment for Total Hip Replacement

0%28 patients

HIV Screening

9%329 patients1/55-star benchmark: 60%

Osteoporosis Management in Women Who Had a Fracture

17%24 patients

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

28%954 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

40%716 patients2/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

15%507 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 91% · 909 patients

Patients screened: 94% · 909 patients

60%81 patients3/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Patients screened: 42% · 267 patients

39%267 patients

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)

Lower rates are better for this measure.

0.04%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

43%348 patients2/55-star benchmark: 98%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

83%357 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 3% · 687 patients

Patients totalRate: 13% · 708 patients

13%708 patients3/55-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.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

4 suppliers14 claims14 services$56.14 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 2

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

GWENDOLEN PHIPPS RN

Registered Nurse

7125 NEW SANGER AVE
WACO, TX 76712

McLennan County (254) 399-5400

GREG PALM PA

Physician Assistant (Surgical)

7125 NEW SANGER AVE, SUITE 516
WACO, TX 76712

McLennan County (254) 752-9638

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 Jerry Benham's NPI number?

The NPI number for Jerry Benham is 1245290972. It was assigned to this individual provider in the NPPES registry on March 25, 2006.

Where is Jerry Benham located?

Jerry Benham practices at 7125 New Sanger Ave Suite 516, Waco, TX 76712. The listed phone number is (254) 752-9638.

What is Jerry Benham's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Jerry Benham enrolled in Medicare?

Yes. Jerry Benham 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 Jerry Benham accept?

Health plans from Blue Cross and Blue Shield of Texas list Jerry Benham 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 Jerry Benham affiliated with any hospitals?

According to CMS data, Jerry Benham is affiliated with Ascension Providence and Parkview Regional Hospital.

When was this NPI record last updated?

The NPPES record for Jerry Benham was last updated on June 25, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.