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BENJAMIN R NEWTON M.D.
NPI 1265520191
Internal Medicine in Waterford, CT

Active since October 10, 2006PECOS EnrolledAccepts Medicare Assignment
93.27/100
CMS Quality Rating
230 WATERFORD PARKWAY SOUTH, SUITE 201, WATERFORD, CT 06385(860) 444-3744(860) 271-4457 Get Directions Write a Review

NPPES record last updated: November 30, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Benjamin R Newton M.d. NPPES

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

BENJAMIN R NEWTON M.D. (NPI 1265520191) is an individual internal medicine provider in Waterford, Connecticut, licensed in Massachusetts (226893) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Westerly Hospital, and is a graduate of Tufts University School Of Medicine (2003).

NPPES Registry Identity

NPI1265520191
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameBENJAMIN R NEWTONCredential: M.D.
Location Address230 WATERFORD PARKWAY SOUTH, SUITE 201Waterford, CT 06385
Mailing Address230 Waterford Parkway South, Suite 201Waterford, CT 06385 · (860) 444-3744 · Fax (860) 271-4457
Phone(860) 444-3744
Fax(860) 271-4457
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 2003
Enumeration DateOctober 10, 2006
Last NPPES UpdateNovember 30, 2015
✔ NPI 1265520191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 226893
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
230 WATERFORD PARKWAY SOUTH, Waterford, CT 06385
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Benjamin R Newton M.d. 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 ID5294807137
PECOS Enrollment IDI20090713000072
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Benjamin Newton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Yale University
40 mi
Anesthesiology
50 DIVISION ST
New Haven, CT 06511
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
NPI 1205822236 (203) 785-2140
Mill Hill Medical Consultants Inc
41 mi
Hospitalist
20 YORK ST, CB 2041
New Haven, CT 06510
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Northeast Medical Group Inc
  • 1,824 clinicians in this Medicare group
NPI 1952624769 (203) 688-4741

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.
449 services184 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.
206 services97 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.
176 services144 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
73 services70 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
53 services37 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.
23 services23 patients

Hospital Affiliations CMS Care Compare

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

Westerly Hospital

Acute Care Hospitals · Westerly, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410013
Location25 Wells StreetWesterly, RI 02891 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06385 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

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.

93.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.72
Promoting Interoperability78.03
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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

Capecitabine, oral, 150 mg J8520
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier14 claims392 services$0.35 avg. paid by Medicare
Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier14 claims1,176 services$0.69 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
1 supplier14 claims20 services$11.95 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Benjamin Newton's NPI number?

The NPI number for Benjamin Newton is 1265520191. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Benjamin Newton located?

Benjamin Newton practices at 230 Waterford Parkway South Suite 201, Waterford, CT 06385. The listed phone number is (860) 444-3744.

What is Benjamin Newton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Benjamin Newton enrolled in Medicare?

Yes. Benjamin Newton 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.

Which organizations bill Medicare for Benjamin Newton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Newton reassigns Medicare benefits to 2 organizations: Yale University (New Haven, CT) and Mill Hill Medical Consultants Inc (New Haven, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Benjamin Newton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Benjamin Newton accept?

Health plans from Anthem Blue Cross and Blue Shield list Benjamin Newton 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 Benjamin Newton affiliated with any hospitals?

According to CMS data, Benjamin Newton is affiliated with Westerly Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Newton was last updated on November 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.