DR. BENJAMIN AUSTIN MARCUM M.D.
NPI 1588892004
Family Medicine in Stephenville, TX

Q: What is Benjamin Marcum's NPI number?

The NPI number for Benjamin Marcum is 1588892004. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Q: What is Benjamin Marcum's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Marcum was last updated on October 6, 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.

Active since June 23, 2009PECOS EnrolledAccepts Medicare Assignment

94.89/100

CMS Quality Rating

150 RIVER NORTH BLVD, STEPHENVILLE, TX 76401(254) 968-6051(254) 968-4950 Get Directions Write a Review

NPPES record last updated: October 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Benjamin Austin Marcum M.d. NPPES

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

DR. BENJAMIN AUSTIN MARCUM M.D. (NPI 1588892004) is an individual family medicine provider in Stephenville, Texas, licensed in Texas (P2728) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Stephenvill, and is a graduate of Eastern Virginia Medical School (2009).

NPPES Registry Identity

NPI1588892004

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. BENJAMIN AUSTIN MARCUMCredential: M.D.

Location Address150 RIVER NORTH BLVDStephenville, TX 76401-1803

Mailing Address150 River North BlvdStephenville, TX 76401-1803 · (254) 968-6051 · Fax (254) 968-4950

Phone(254) 968-6051

Fax(254) 968-4950

Sole ProprietorNo

Medical School CMSEastern Virginia Medical SchoolGraduated 2009

Enumeration DateJune 23, 2009

Last NPPES UpdateOctober 6, 2022

NPPES CertifiedOctober 6, 2022

✔ NPI 1588892004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in TX · P2728✔ Licensed in ID · MR-1063

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

150 RIVER NORTH BLVD, Stephenville, TX 76401

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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 Austin Marcum 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 ID1557517547

PECOS Enrollment IDI20120807000478

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

Medicare enrollment records show Benjamin Marcum reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Texas Health Care, P.L.L.C.

41 mi

Ophthalmology

1100 SE 1ST ST, SUITE A
Mineral Wells, TX 76067

Reassigned Medicare billing, Texas enrollment
Medicare enrollment name: Texas Health Care PLLC
511 clinicians in this Medicare group

NPI 1083770325 (940) 325-7700

Concord Medical Group PLLC

230 mi

Emergency Medicine

1602 AVENUE Q
Lubbock, TX 79401

Reassigned Medicare billing, Texas enrollment
1,338 clinicians in this Medicare group

NPI 1083630610 (888) 264-0330

Concord Medical Group Of Texas PLLC

231 mi

Emergency Medicine

1602 AVENUE Q
Lubbock, TX 79401

Reassigned Medicare billing, Texas enrollment
1,439 clinicians in this Medicare group

NPI 1750790762 (888) 264-0330

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 32

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

593 services218 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

402 services47 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

368 services195 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

314 services190 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

262 services179 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

193 services163 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

174 services157 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

163 services163 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

160 services145 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

160 services145 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

159 services155 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

155 services155 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

114 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

81 services80 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

77 services76 patients

Screening 3d breast mammography 77063

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

61 services61 patients

Screening mammography 77067

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

60 services60 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.

59 services49 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

50 services46 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

43 services21 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

35 services30 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

22 services11 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

21 services19 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

16 services11 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

16 services13 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

14 services14 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

13 services11 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

12 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

12 services12 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

12 services12 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

11 services11 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Texas Health Harris Methodist Hospital Stephenvill

Acute Care Hospitals · Stephenville, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number450351

Location411 N Belknap StStephenville, TX 76401 · Erath County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76401 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

94.89/100

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

Scored through an Alternative Payment Model

Quality

89.79

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 14

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers34 claims124 services$5.55 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers18 claims37 services$0.90 avg. paid by Medicare

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394

DME-Orthotic Devices · category DF010N

3 suppliers30 claims472 services$2.16 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

3 suppliers20 claims1,351 services$0.22 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers17 claims40 services$37.73 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers13 claims13 services$21.63 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.

CHRISTY LYNN KERR M.D.

Family Medicine

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

DR. SREENIVAS GUDIMETLA M.D.

Internal Medicine (Cardiovascular Disease)

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

MS. ANITA BUTLER RD, LD

Nutritionist (Nutrition, Education)

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

DR. JANIE MCMILLION M.D.

Obstetrics & Gynecology

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

EYE CARE CONSULTANTS, PLLC

Ophthalmology

150 RIVER NORTH BLVD, SUITE A
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

DR. KAM IP M.D.

Family Medicine

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

CLAYTON K ROBERTS D.O.

Family Medicine

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

MR. DOROTHY SAXON R.N. G.N.P.

Nurse Practitioner (Gerontology)

150 RIVER NORTH BLVD
STEPHENVILLE, TX 76401

Erath County (254) 968-6051

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 Marcum's NPI number?

The NPI number for Benjamin Marcum is 1588892004. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Where is Benjamin Marcum located?

Benjamin Marcum practices at 150 River North Blvd, Stephenville, TX 76401. The listed phone number is (254) 968-6051.

What is Benjamin Marcum's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Benjamin Marcum enrolled in Medicare?

Yes. Benjamin Marcum 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 Benjamin Marcum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Marcum reassigns Medicare benefits to 3 organizations: Texas Health Care, P.L.L.C. (Mineral Wells, TX), Concord Medical Group PLLC (Lubbock, TX) and Concord Medical Group Of Texas PLLC (Lubbock, TX). 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 Benjamin Marcum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Benjamin Marcum accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Benjamin Marcum 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 Marcum affiliated with any hospitals?

According to CMS data, Benjamin Marcum is affiliated with Texas Health Harris Methodist Hospital Stephenvill.

When was this NPI record last updated?

The NPPES record for Benjamin Marcum was last updated on October 6, 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.