DOUGLAS W BENKELMAN MD
NPI 1518926567
Emergency Medicine in Winchester, VA

Q: What is Douglas Benkelman's NPI number?

The NPI number for Douglas Benkelman is 1518926567. It was assigned to this individual provider in the NPPES registry on March 20, 2006.

Q: What is Douglas Benkelman's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Douglas Benkelman was last updated on January 27, 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 March 20, 2006PECOS EnrolledAccepts Medicare Assignment

1840 AMHERST ST, WINCHESTER, VA 22601(540) 536-8000(540) 536-7681 Get Directions Write a Review

NPPES record last updated: January 27, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jan 27, 2023, Feb 27, 2021 (2 updates tracked since 2021).

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About Douglas W Benkelman Md NPPES

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

DOUGLAS W BENKELMAN MD (NPI 1518926567) is an individual emergency medicine provider in Winchester, Virginia, licensed in Virginia (0101233812) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and is a graduate of University Of Missouri, Columbia School Of Medicine (1995).

NPPES Registry Identity

NPI1518926567

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDOUGLAS W BENKELMANCredential: MD

Location Address1840 AMHERST STWinchester, VA 22601-2808

Mailing Address1840 Amherst StWinchester, VA 22601-2808 · (540) 536-8000 · Fax (540) 536-7681

Phone(540) 536-8000

Fax(540) 536-7681

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1995

Enumeration DateMarch 20, 2006

Last NPPES UpdateJanuary 27, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 27, 2023

✔ NPI 1518926567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in VA · 0101233812

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.

1840 AMHERST ST, Winchester, VA 22601

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Other Identifiers 2

Medicaid010206375VA

Medicaid3810003606WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Douglas W Benkelman 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 ID1759364151

PECOS Enrollment IDI20160426002122

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.

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.

86 services85 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

54 services54 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

30 services30 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.

17 services17 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

16 services16 patients

Hospital Affiliations CMS Care Compare

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

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510008

Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22601 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers19 claims19 services$16.73 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 suppliers19 claims19 services$86.86 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.

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