1. Home
  2. Directory
  3. Mississippi
  4. Jackson
  5. Emergency Medicine
  6. NPI Profile

BENJAMIN ILLICH
NPI 1508277609
Emergency Medicine in Jackson, MS

Active since May 12, 2014PECOS EnrolledAccepts Medicare Assignment
2500 N STATE ST, JACKSON, MS 39216(228) 984-5582 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 4, 2022, Jan 25, 2017 (2 updates tracked since 2017).

About Benjamin Illich NPPES

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

BENJAMIN ILLICH (NPI 1508277609) is an individual emergency medicine provider in Jackson, Mississippi, licensed in Mississippi (24710) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1508277609
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameBENJAMIN ILLICH
Location Address2500 N STATE STJackson, MS 39216-4500
Mailing Address2500 N State StJackson, MS 39216-4500 · (228) 984-5582
Phone(228) 984-5582
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMay 12, 2014
Last NPPES UpdateFebruary 4, 20222 updates tracked since enumeration
✔ NPI 1508277609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MS · 24710
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 390200000 (MS)
2500 N STATE ST, Jackson, MS 39216
Open in Google Maps ↗

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 Illich 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 ID4981929015
PECOS Enrollment IDI20221002000008
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

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.

LAMAR DAVIS II M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5275
STEPHEN COMMISKEY M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
JESSICA SAFLEY MD
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
DR. MARY KINNEY LOWE CORLEY MD
Obstetrics & Gynecology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5339
LAURA ELIZABETH VEARRIER M.D.
Emergency Medicine
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 815-2005
DR. CANDICE BRITTANY APRIL DDS
Dentist
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-6028
DR. LARKIN H MITCHELL M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
EMILY SUMRALL CHILDRESS CRNA
Nurse Anesthetist, Certified Registered
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-1000

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 Illich's NPI number?

The NPI number for Benjamin Illich is 1508277609. It was assigned to this individual provider in the NPPES registry on May 12, 2014.

Where is Benjamin Illich located?

Benjamin Illich practices at 2500 N State St, Jackson, MS 39216. The listed phone number is (228) 984-5582.

What is Benjamin Illich's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Benjamin Illich enrolled in Medicare?

Yes. Benjamin Illich 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.

When was this NPI record last updated?

The NPPES record for Benjamin Illich was last updated on February 4, 2022. 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.