BENJAMIN HEYEN M.D.
NPI 1649621038
Family Medicine in Marion, NC

Q: What is Benjamin Heyen's NPI number?

The NPI number for Benjamin Heyen is 1649621038. It was assigned to this individual provider in the NPPES registry on June 27, 2016.

Q: What is Benjamin Heyen'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 Heyen was last updated on June 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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 27, 2016PECOS EnrolledAccepts Medicare Assignment

99.72/100

CMS Quality Rating

1633 SUGAR HILL RD, MARION, NC 28752(828) 652-7776 Get Directions Write a Review

NPPES record last updated: June 20, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 20, 2025, Jun 27, 2016 (2 updates tracked since 2016).

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About Benjamin Heyen M.d. NPPES

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

BENJAMIN HEYEN M.D. (NPI 1649621038) is an individual family medicine provider in Marion, North Carolina, licensed in North Carolina (2019-00265) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with The Mcdowell Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1649621038

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameBENJAMIN HEYENCredential: M.D.

Location Address1633 SUGAR HILL RDMarion, NC 28752-5239

Mailing Address1633 Sugar Hill RdMarion, NC 28752-5239 · (828) 652-7776

Phone(828) 652-7776

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJune 27, 2016

Last NPPES UpdateJune 20, 20252 updates tracked since enumeration

NPPES CertifiedJune 20, 2025

✔ NPI 1649621038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in NC · 2019-00265✔ Licensed in FL · 23600

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.

1633 SUGAR HILL RD, Marion, NC 28752

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.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

Benjamin Heyen 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 ID8820385628

PECOS Enrollment IDI20180926003629, I20190903002145

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.

Hospital Affiliations CMS Care Compare

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

The Mcdowell Hospital

Acute Care Hospitals · Marion, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340087

Location430 Rankin Drive P O Box 730Marion, NC 28752 · Mc Dowell County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28752 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

99.72/100

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

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%1,098 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

23%164 patients2/55-star benchmark: 88%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 11

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 suppliers17 claims40 services$6.59 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

1 supplier11 claims11 services$16.71 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier13 claims20 services$13.82 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers21 claims37 services$49.46 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

4 suppliers54 claims56 services$107.06 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers31 claims33 services$36.75 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 14

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

MH MISSION HOSPITAL MCDOWELL, LLLP

Clinic/Center (Radiology)