BENJAMIN NICHOLAS MD
NPI 1336631381
Internal Medicine in West Reading, PA

Q: What is Benjamin Nicholas's NPI number?

The NPI number for Benjamin Nicholas is 1336631381. It was assigned to this individual provider in the NPPES registry on June 5, 2018.

Q: What is Benjamin Nicholas's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Benjamin Nicholas was last updated on June 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 June 05, 2018PECOS EnrolledAccepts Medicare Assignment

94.69/100

CMS Quality Rating

420 S 5TH AVE, WEST READING, PA 19611(484) 628-8640(484) 628-9003 Get Directions Write a Review

NPPES record last updated: June 5, 2018. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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About Benjamin Nicholas Md NPPES

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

BENJAMIN NICHOLAS MD (NPI 1336631381) is an individual internal medicine provider in West Reading, Pennsylvania, licensed in Pennsylvania (MT215514) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Hahnemann University College Of Medicine (2018).

NPPES Registry Identity

NPI1336631381

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameBENJAMIN NICHOLASCredential: MD

Location Address420 S 5TH AVEWest Reading, PA 19611-2143

Mailing AddressPo Box 13579Reading, PA 19612-3579

Phone(484) 628-8640

Fax(484) 628-9003

Sole ProprietorNo

Medical School CMSHahnemann University College Of MedicineGraduated 2018

Enumeration DateJune 5, 2018

✔ NPI 1336631381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MT215514

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.

420 S 5TH AVE, West Reading, PA 19611

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Highmark Blue Cross Blue Shield Delaware and more.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

Benjamin Nicholas 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 ID1850647413

PECOS Enrollment IDI20220725000303

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 17

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.

310 services202 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

234 services204 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.

126 services98 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

124 services108 patients

Closure of tear duct opening using plug 68761

Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.

122 services76 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

119 services93 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

78 services45 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

77 services65 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.

77 services77 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

73 services56 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

65 services59 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

60 services36 patients

Exam to measure eye deviation and range of motion 92060

This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.

58 services33 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

45 services30 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

41 services41 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

35 services32 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

23 services23 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

94.69/100

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

Scored as part of a group practice

Quality

99.16

Improvement Activities

Cost

83.44

Other Providers at the Same Location NPPES 20

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

TOLUWANIMI OGBONMIDE

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

URVASHI SARKAR

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

MADISON HECK

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

NEIL HOFFMAN M.D.

Pathology (Forensic Pathology)

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8615

MS. LANE ROSCOE PA- C

Physician Assistant

420 S 5TH AVE
WEST READING, PA 19611

Berks County (610) 568-3637

ALICE LEE DO

Surgery

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-4879

KYLE ROMPALA

Nurse Practitioner (Family)

420 S 5TH AVE
READING, PA 19611

Berks County (267) 280-7615

MATTHEW CRYER

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-1324

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 Nicholas's NPI number?

The NPI number for Benjamin Nicholas is 1336631381. It was assigned to this individual provider in the NPPES registry on June 5, 2018.

Where is Benjamin Nicholas located?

Benjamin Nicholas practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-8640.

What is Benjamin Nicholas's specialty?

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

Is Benjamin Nicholas enrolled in Medicare?

Yes. Benjamin Nicholas 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 Benjamin Nicholas accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Highmark Blue Cross Blue Shield Delaware, Highmark Blue Cross Blue Shield West Virginia and Providence Health Plan list Benjamin Nicholas 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 Nicholas affiliated with any hospitals?

According to CMS data, Benjamin Nicholas is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Nicholas was last updated on June 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.