1. Home
  2. Directory
  3. Virginia
  4. Winchester
  5. Emergency Medicine
  6. NPI Profile

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

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: November 08, 2026.

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

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
Open in Google Maps ↗

Other Identifiers 2

Medicaid010206375VA
Medicaid3810003606WV

Accepted Insurance

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

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.

Medicare Billing Reassignments

6

Medicare enrollment records show Douglas Benkelman reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Winchester Medical Center
Same address
Critical Care Medicine
1840 AMHERST ST
Winchester, VA 22601
  • Reassigned Medicare billing, Virginia enrollment
  • 756 clinicians in this Medicare group
NPI 1679711261 (540) 536-8000
Winchester Medical Center Inc.
Same address
Emergency Care
1840 AMHERST ST
Winchester, VA 22601
  • Reassigned Medicare billing, Virginia enrollment
  • 37 clinicians in this Medicare group
NPI 1487907341 (540) 536-8700
City Hospital, Inc.
19 mi
Internal Medicine
207 E 5TH AVE
Ranson, WV 25438
  • Reassigned Medicare billing, West Virginia enrollment
  • 231 clinicians in this Medicare group
NPI 1336657493 (304) 725-6777
War Memorial Hospital, Inc.
25 mi
Critical Access
1 HEALTHY WAY
Berkeley Springs, WV 25411
  • Reassigned Medicare billing, West Virginia enrollment
  • 158 clinicians in this Medicare group
NPI 1467450353 (304) 258-1234
Hampshire Memorial Hospital, Inc.
29 mi
Critical Access
363 SUNRISE BLVD
Romney, WV 26757
  • Reassigned Medicare billing, West Virginia enrollment
  • 156 clinicians in this Medicare group
NPI 1396897203 (304) 822-4561
Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc
39 mi
Health Maintenance Organization
19450 DEERFIELD AVE
Lansdowne, VA 20176
  • Reassigned Medicare billing, Virginia and District of Columbia enrollments
  • Also billed through NPI 1831471713 (District of Columbia), NPI 1073678637 (District of Columbia), NPI 1114677572 (Virginia)
  • 995 clinicians in this Medicare group
NPI 1225156367 (703) 726-2100

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 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.

AKHILA SURE M.D.
Surgery (Surgical Critical Care)
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8000
JILLIAN H CALL MD
Emergency Medicine
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8000
MICHAEL MAYER ROMAIN KHAFI DO
Emergency Medicine
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8000
RAMZIDDIN KHALMURATOV PA-C
Physician Assistant
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-4555
MEAGHAN PETERS CSFA
Specialist/Technologist, Other (Surgical Assistant)
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8000
JOEL A RHODES CRNA
Nurse Anesthetist, Certified Registered
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8000
BEVIN MARIE SANBORN LCSW
Social Worker (Clinical)
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-5191
T. GLEN BOUDER MD
Internal Medicine (Critical Care Medicine)
1840 AMHERST ST
WINCHESTER, VA 22601
Winchester City (540) 536-8874

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 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.

Where is Douglas Benkelman located?

Douglas Benkelman practices at 1840 Amherst St, Winchester, VA 22601. The listed phone number is (540) 536-8000.

What is Douglas Benkelman's specialty?

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

Is Douglas Benkelman enrolled in Medicare?

Yes. Douglas Benkelman 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 organizations bill Medicare for Douglas Benkelman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Benkelman reassigns Medicare benefits to 6 organizations: Winchester Medical Center (Winchester, VA), Winchester Medical Center Inc. (Winchester, VA), City Hospital, Inc. (Ranson, WV), War Memorial Hospital, Inc. (Berkeley Springs, WV), Hampshire Memorial Hospital, Inc. (Romney, WV) and 1 more organization, listed in the Medicare section above. Each 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 Douglas Benkelman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Benkelman accept?

Health plans from Peak Health Insurance list Douglas Benkelman 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 Douglas Benkelman affiliated with any hospitals?

According to CMS data, Douglas Benkelman is affiliated with Berkeley Medical Center.

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.