DR. BENJAMIN T ESPARAZ M.D.
NPI 1275502940
Internal Medicine - Hematology & Oncology in Decatur, IL

Q: What is Benjamin Esparaz's NPI number?

The NPI number for Benjamin Esparaz is 1275502940. It was assigned to this individual provider in the NPPES registry on March 15, 2006.

Q: What is Benjamin Esparaz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Esparaz was last updated on December 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 March 15, 2006PECOS Enrolled

77.67/100

CMS Quality Rating

210 W MCKINLEY AVE STE 1, DECATUR, IL 62526(217) 876-6600(217) 876-6606 Get Directions Write a Review

NPPES record last updated: December 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Benjamin T Esparaz M.d. NPPES

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

DR. BENJAMIN T ESPARAZ M.D. (NPI 1275502940) is an individual hematology & oncology provider in Decatur, Illinois, licensed in Illinois (036071926) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275502940

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameDR. BENJAMIN T ESPARAZCredential: M.D.

Location Address210 W MCKINLEY AVE STE 1Decatur, IL 62526-5858

Mailing Address210 W Mckinley Ave Ste 1Decatur, IL 62526-5858 · (217) 876-6600 · Fax (217) 876-6606

Phone(217) 876-6600

Fax(217) 876-6606

Sole ProprietorNo

Enumeration DateMarch 15, 2006

Last NPPES UpdateDecember 9, 2021

NPPES CertifiedDecember 9, 2021

✔ NPI 1275502940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in IL · 036071926

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

210 W MCKINLEY AVE STE 1, Decatur, IL 62526

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Benjamin T Esparaz M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 19

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

3,100 services24 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.

215 services141 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.

189 services86 patients

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.

115 services72 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

87 services70 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

59 services53 patients

Microscopic examination for white blood cells with manual cell count 85007

This is a lab test where a small sample of your blood is studied under a microscope. The goal is to count the number of white blood cells, which are crucial for your body's immune response. The count can help identify potential health issues.

42 services31 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

42 services31 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

32 services32 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

31 services30 patients

Nuclear medicine study from skull base to mid-thigh with ct scan 78815

A nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.

27 services22 patients

Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries A9552

Fluorodeoxyglucose F-18 FDG is a radioactive drug used in PET scans. It helps doctors see how your tissues and organs are functioning. The drug is given in a specific dose, up to 45 millicuries, depending on your body size and the type of scan.

26 services20 patients

Cyanocobalamin (vitamin b-12) level 82607

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

13 services13 patients

Ferritin (blood protein) level 82728

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

13 services13 patients

Iron level 83540

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

13 services13 patients

Iron binding capacity 83550

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

13 services13 patients

Folic acid level, serum 82746

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

12 services12 patients

Carcinoembryonic antigen (cea) protein level 82378

Carcinoembryonic Antigen (CEA) protein level is a blood test often used in cancer care. It measures the amount of CEA protein in your blood, which can increase in cases of certain types of cancer. It's used to monitor treatment progress and check for cancer recurrence.

11 services11 patients

Red blood count, automated test 85045

An automated red blood count test is a routine lab procedure to measure the number of red blood cells in your blood. These cells carry oxygen throughout the body. The test helps assess overall health and detect conditions like anemia or polycythemia.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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

$168.44 typical visit price

range $54.80 – $168.44

Typical copayment $42.11 (range $13.70 – $42.11)

Most-billed visit code 99205

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

77.67/100

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

Scored as part of a group practice

Quality

73.39

Promoting Interoperability

Improvement Activities

Cost

52.7

Referred Medical Equipment & Supplies CMS DME claims 4

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

Capecitabine, oral, 500 mg J8521

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers12 claims1,020 services$0.75 avg. paid by Medicare

Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type L8000

DME-Orthotic Devices · category DF000N

5 suppliers33 claims108 services$33.95 avg. paid by Medicare

Breast prosthesis, silicone or equal, without integral adhesive L8030

DME-Orthotic Devices · category DF000N

3 suppliers14 claims23 services$290.18 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

2 suppliers11 claims11 services$12.58 avg. paid by Medicare

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

Leave this field empty

Other Providers at the Same Location NPPES 7

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

THOMAS H TARTER M.D.

Surgery (Surgical Oncology)