DR. BENJAMIN JOHN ERNST M.D.
NPI 1518162247
Ophthalmology - Retina Specialist in Appleton, WI

Q: What is Benjamin Ernst's NPI number?

The NPI number for Benjamin Ernst is 1518162247. It was assigned to this individual provider in the NPPES registry on June 21, 2007.

Q: What is Benjamin Ernst's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Ernst was last updated on September 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 21, 2007PECOS EnrolledAccepts Medicare Assignment

442 N WESTHILL BLVD STE A, APPLETON, WI 54914(920) 751-8666 Get Directions Write a Review

NPPES record last updated: September 21, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Benjamin John Ernst M.d. NPPES

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

DR. BENJAMIN JOHN ERNST M.D. (NPI 1518162247) is an individual retina specialist in Appleton, Wisconsin, licensed in Wisconsin (57459020) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of Saint Louis University School Of Medicine (2006).

NPPES Registry Identity

NPI1518162247

Entity TypeIndividualMale

Primary Taxonomy207WX0107X

Provider Legal NameDR. BENJAMIN JOHN ERNSTCredential: M.D.

Location Address442 N WESTHILL BLVD STE AAppleton, WI 54914-5830

Mailing Address442 N Westhill Blvd Ste AAppleton, WI 54914-5830 · (920) 751-8666 · Fax (920) 751-0288

Phone(920) 751-8666

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2006

Enumeration DateJune 21, 2007

Last NPPES UpdateSeptember 21, 2023

NPPES CertifiedSeptember 21, 2023

✔ NPI 1518162247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

License✔ Licensed in WI · 57459020

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X · License 48790 (CO)

442 N WESTHILL BLVD STE A, Appleton, WI 54914

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan 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

Dr. Benjamin John Ernst 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 ID1557485992

PECOS Enrollment IDI20120824000125

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 Ernst reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northeast Wisconsin Retina Associates Sc

Same address

Retina Specialist

442 N WESTHILL BLVD STE A
Appleton, WI 54914

Reassigned Medicare billing, Wisconsin enrollment
7 clinicians in this Medicare group

NPI 1437164175 (920) 751-8666

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 13

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.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

6,000 services24 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.

1,400 services392 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

1,152 services227 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

956 services80 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

764 services156 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

334 services188 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.

70 services68 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.

68 services68 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.

52 services52 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.

46 services45 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

17 services17 patients

Photocoagulation treatment to prevent detachment of retina 67145

Photocoagulation is a procedure used to treat retinal disorders. A special laser is directed at the retina to create small burns. These burns form scar tissue which helps to secure the retina to the eye's wall, preventing detachment and preserving vision.

16 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54914 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

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 3

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

ANTHONY PARENDO M.D.

Ophthalmology (Retina Specialist)

442 N WESTHILL BLVD STE A
APPLETON, WI 54914

Outagamie County (920) 751-8666

NORTHEAST WISCONSIN RETINA ASSOCIATES SC

Ophthalmology (Retina Specialist)

442 N WESTHILL BLVD STE A
APPLETON, WI 54914

Outagamie County (920) 751-8666

MICHAEL EDWARD POSSIN M.D.

Ophthalmology (Retina Specialist)

442 N WESTHILL BLVD STE A
APPLETON, WI 54914

Outagamie County (920) 751-8666

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 Ernst's NPI number?

The NPI number for Benjamin Ernst is 1518162247. It was assigned to this individual provider in the NPPES registry on June 21, 2007.

Where is Benjamin Ernst located?

Benjamin Ernst practices at 442 N Westhill Blvd Ste A, Appleton, WI 54914. The listed phone number is (920) 751-8666.

What is Benjamin Ernst's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Benjamin Ernst enrolled in Medicare?

Yes. Benjamin Ernst 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 Ernst's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Ernst reassigns Medicare benefits to Northeast Wisconsin Retina Associates Sc (Appleton, WI). 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 Ernst's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Benjamin Ernst accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan, HealthPartners and Network Health and 2 other insurers list Benjamin Ernst 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 Ernst affiliated with any hospitals?

According to CMS data, Benjamin Ernst is affiliated with Thedacare Regional Med Ctr - Neenah and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Ernst was last updated on September 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.