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DR. BENJAMIN F GUINEY JR. M.D.
NPI 1376693317
Family Medicine in Cherokee, NC

Active since January 11, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1 HOSPITAL RD, CHEROKEE, NC 28719(828) 497-9163 Get Directions Write a Review

NPPES record last updated: December 30, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Benjamin F Guiney Jr. M.d. NPPES

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

DR. BENJAMIN F GUINEY JR. M.D. (NPI 1376693317) is an individual family medicine provider in Cherokee, North Carolina, licensed in North Carolina (2014-00119) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Harris Regional Hospital, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1376693317
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. BENJAMIN F GUINEY JR.Credential: M.D.
Location Address1 HOSPITAL RDCherokee, NC 28719
Mailing Address170 Ridgeway StSylva, NC 28779-5494 · (828) 222-0416
Phone(828) 497-9163
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJanuary 11, 2007
Last NPPES UpdateDecember 30, 2014
✔ NPI 1376693317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in NC · 2014-00119✔ Licensed in WA · MD00047012
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 2014-00119 (NC)
1 HOSPITAL RD, Cherokee, NC 28719
Open in Google Maps ↗

Other Identifiers 4

Medicaid1780614008AZ
Medicaid1629236716AZ
Medicaid1295993376AZ
Medicaid1871523191AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Plan of North Carolina, Inc, Oscar Insurance Company.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

Dr. Benjamin F Guiney Jr. 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 ID6002906229
PECOS Enrollment IDI20071212000128, I20140328001132
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 5

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
206 services196 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
105 services102 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
68 services66 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
25 services24 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Harris Regional Hospital

Acute Care Hospitals · Sylva, NC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number340016
Location68 Hospital RdSylva, NC 28779 · Jackson County
Emergency services Birthing friendly

Cherokee Indian Hospital Authority

Acute Care Hospitals · Cherokee, NC
OwnershipGovernment - Federal
CMS Certification Number340156
LocationCaller Box C268Cherokee, NC 28719 · Swain County
Emergency services

Dlp Swain County Hospital LLC

Critical Access Hospitals · Bryson City, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number341305
Location45 Plateau StreetBryson City, NC 28713 · Swain County
Emergency services

Erlanger Murphy Medical Center

Critical Access Hospitals · Murphy, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number341328
Location3990 East Us Highway 64 AltMurphy, NC 28906 · Cherokee County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28719 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

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.

ASHLEY KEEL
Peer Specialist
1 HOSPITAL RD, CALLER BOX C-268
CHEROKEE, NC 28719
Swain County (828) 497-9163
JUSTICE LEE LITTLEJOHN PSS
Peer Specialist
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
KYLEE SAVAGE
Physician Assistant
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
MRS. KELLIE LEIGH BROWN MSW, LCSW-A
Social Worker (Clinical)
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
AMANDA HARRIS LEDFORD
Physical Therapy Assistant
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
ELIZABETH COLEMAN MCDONALD FNP-C
Nurse Practitioner (Family)
1 HOSPITAL RD, CALLER BOX C-268
CHEROKEE, NC 28719
Swain County (828) 497-9163
SHELBY CANNON HEATH M.S., CCC-SLP
Speech-Language Pathologist
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
ANEKA DIERA PHARMD
Pharmacist
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163

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 Guiney's NPI number?

The NPI number for Benjamin Guiney is 1376693317. It was assigned to this individual provider in the NPPES registry on January 11, 2007.

Where is Benjamin Guiney located?

Benjamin Guiney practices at 1 Hospital Rd, Cherokee, NC 28719. The listed phone number is (828) 497-9163.

What is Benjamin Guiney's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Benjamin Guiney enrolled in Medicare?

Yes. Benjamin Guiney 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 Guiney accept?

Health plans from Oscar Health Plan of North Carolina, Inc and Oscar Insurance Company list Benjamin Guiney 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 Guiney affiliated with any hospitals?

According to CMS data, Benjamin Guiney is affiliated with Harris Regional Hospital, Cherokee Indian Hospital Authority, Dlp Swain County Hospital LLC and Erlanger Murphy Medical Center.

When was this NPI record last updated?

The NPPES record for Benjamin Guiney was last updated on December 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.