BENJAMIN P DALTON MD
NPI 1396979936
Internal Medicine - Gastroenterology in Knoxville, TN

Q: What is Benjamin Dalton's NPI number?

The NPI number for Benjamin Dalton is 1396979936. It was assigned to this individual provider in the NPPES registry on May 12, 2009.

Q: What is Benjamin Dalton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Dalton was last updated on February 15, 2016. 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.

Active since May 12, 2009PECOS EnrolledAccepts Medicare Assignment

95.69/100

CMS Quality Rating

1928 ALCOA HWY, STE 100, KNOXVILLE, TN 37920(865) 305-6570(865) 305-6576 Get Directions Write a Review

NPPES record last updated: February 15, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Benjamin P Dalton Md NPPES

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

BENJAMIN P DALTON MD (NPI 1396979936) is an individual gastroenterology provider in Knoxville, Tennessee, licensed in Tennessee (53046) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of Jc Edwards School Of Medicine, Marshall University (2009).

NPPES Registry Identity

NPI1396979936

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameBENJAMIN P DALTONCredential: MD

Location Address1928 ALCOA HWY, STE 100Knoxville, TN 37920-1502

Mailing AddressPo Box 440395Nashville, TN 37244-0395 · (865) 670-6199 · Fax (865) 670-6198

Phone(865) 305-6570

Fax(865) 305-6576

Sole ProprietorNo

Medical School CMSJc Edwards School Of Medicine, Marshall UniversityGraduated 2009

Enumeration DateMay 12, 2009

Last NPPES UpdateFebruary 15, 2016

✔ NPI 1396979936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in TN · 53046

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1928 ALCOA HWY, Knoxville, TN 37920

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Other Identifiers 2

MedicaidQ016273TN

Medicare PIN103I113222TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company and more.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 P Dalton 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 ID8628387966

PECOS Enrollment IDI20151027002228

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 Reassignment

Medicare enrollment records show Benjamin Dalton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Health System Inc

Same address

Diagnostic Radiology

1928 ALCOA HWY STE 315
Knoxville, TN 37920

Reassigned Medicare billing, Tennessee enrollment
832 clinicians in this Medicare group

NPI 1639894397 (865) 558-0225

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 12

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 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.

142 services112 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

79 services79 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

75 services74 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.

51 services51 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

48 services48 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.

31 services31 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

26 services26 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

19 services19 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.

14 services11 patients

Study of esophagus to assess movement 91010

This procedure, known as esophageal manometry, involves studying the esophagus or food pipe to evaluate its movement and pressure. It helps understand how well the esophagus can move food to the stomach. Involving a thin, flexible tube, it's a safe, minimally invasive test.

13 services13 patients

Monitoring and recording of esophageal function through nasal tube with electrode 91037

This procedure involves placing a thin tube with an electrode through your nose and into your esophagus. It helps to monitor and record the function of your esophagus, aiding in diagnosing any potential issues.

12 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

University Health System, Inc

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440015

Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37920 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

95.69/100

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

Scored through an Alternative Payment Model

Quality

85.28

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients

Percentage of patients aged 50 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of at least 10 years for repeat colonoscopy documented in their colonoscopy report

87%39 patients

Appropriate indication for colonoscopy

Percentage of colonoscopy procedures performed for an indication that is included in a published standard list of appropriate indications and the indication is documented

86%388 patients3/55-star benchmark: 99%

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 4

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

3 suppliers18 claims18 services$40.35 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier13 claims13 services$34.64 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers23 claims24 services$67.75 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier20 claims21 services$36.00 avg. paid by Medicare

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

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.

DR. KATHERINE BONNER KAAK MD

Student in an Organized Health Care Education/Training Program

1928 ALCOA HWY
KNOXVILLE, TN 37920

Knox County (865) 305-8787

DR. MARK D ANDERSON MD

Internal Medicine (Gastroenterology)

1928 ALCOA HWY, B100
KNOXVILLE, TN 37920

Knox County (865) 544-6570

DR. DREW WILSON MILLER M.D.

Dermatology (MOHS-Micrographic Surgery)

1928 ALCOA HWY, STE 209
KNOXVILLE, TN 37920

Knox County (865) 524-2547

THOMAS L YOUNG MD

Internal Medicine (Gastroenterology)

1928 ALCOA HWY, STE 105
KNOXVILLE, TN 37920

Knox County (865) 305-9595

KNOXVILLE DERMATOLOGY GROUP PC

Dermatology

1928 ALCOA HWY, SUITE 209
KNOXVILLE, TN 37920

Knox County (865) 690-9467

DR. JACLYN BETH VAN NES M.D.

Obstetrics & Gynecology

1928 ALCOA HWY, MEDICAL BUILDING B SUITE 300
KNOXVILLE, TN 37920

Knox County (865) 305-9799

HUMBERTO RODRIGUEZ MD

Obstetrics & Gynecology (Gynecology)

1928 ALCOA HWY, STE 303
KNOXVILLE, TN 37920

Knox County (865) 305-9305

UNIVERSITY HEALTH SYSTEM, INC

Psychiatry & Neurology (Neurology)

1928 ALCOA HWY, STE 102
KNOXVILLE, TN 37920

Knox County (865) 305-6640

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 Dalton's NPI number?

The NPI number for Benjamin Dalton is 1396979936. It was assigned to this individual provider in the NPPES registry on May 12, 2009.

Where is Benjamin Dalton located?

Benjamin Dalton practices at 1928 Alcoa Hwy Ste 100, Knoxville, TN 37920. The listed phone number is (865) 305-6570.

What is Benjamin Dalton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Benjamin Dalton enrolled in Medicare?

Yes. Benjamin Dalton 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 organization bills Medicare for Benjamin Dalton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Dalton reassigns Medicare benefits to University Health System Inc (Knoxville, TN). The 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 Dalton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Benjamin Dalton accept?

Health plans from BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company and UnitedHealthcare list Benjamin Dalton 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 Dalton affiliated with any hospitals?

According to CMS data, Benjamin Dalton is affiliated with University Health System, Inc.

When was this NPI record last updated?

The NPPES record for Benjamin Dalton was last updated on February 15, 2016. 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.