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BENJAMIN J BORTON D-NP
NPI 1740799451
Nurse Practitioner in Muskegon, MI

Active since September 26, 2017PECOS EnrolledAccepts Medicare Assignment
1675 LEAHY ST STE 215A, MUSKEGON, MI 49442(616) 685-3098(616) 685-3095 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 8, 2024, Dec 7, 2021 (2 updates tracked since 2021).

About Benjamin J Borton D-np NPPES

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

BENJAMIN J BORTON D-NP (NPI 1740799451) is an individual nurse practitioner in Muskegon, Michigan, licensed in Michigan (4704289708) and active in the NPI registry since September 2017. He is enrolled in Medicare PECOS, is affiliated with Mercy Health Saint Mary's, and is a graduate of University Of Michigan Medical School (2017).

NPPES Registry Identity

NPI1740799451
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameBENJAMIN J BORTONCredential: D-NP
Location Address1675 LEAHY ST STE 215AMuskegon, MI 49442-5500
Mailing Address1675 Leahy St Ste 215aMuskegon, MI 49442-5500 · (231) 672-2120
Phone(616) 685-3098
Fax(616) 685-3095
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 2017
Enumeration DateSeptember 26, 2017
Last NPPES UpdateFebruary 8, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2024
✔ NPI 1740799451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MI · 4704289708
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1675 LEAHY ST STE 215A, Muskegon, MI 49442
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company 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 J Borton D-np 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 ID6406122571
PECOS Enrollment IDI20171018001315
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 3

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.
188 services131 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
124 services92 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
18 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Mercy Health Saint Mary's

Acute Care Hospitals · Grand Rapids, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230066
Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49442 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
79%33 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
75%61 patients4/55-star benchmark: 85%
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%807 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…
9%171 patients1/55-star benchmark: 88%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%173 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
32%111 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%172 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
30%172 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
33%172 patients
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 6

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
5 suppliers42 claims512 services$18.49 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
5 suppliers41 claims1,290 services$2.33 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers23 claims130 services$6.38 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers36 claims36 services$297.18 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
5 suppliers17 claims2,260 services$7.27 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
11 suppliers309 claims309 services$180.85 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 2

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

BRYN JOELLE PAPE DO
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1675 LEAHY ST STE 215A
MUSKEGON, MI 49442
Muskegon County (616) 685-3098
ANITA EAPEN MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1675 LEAHY ST STE 215A
MUSKEGON, MI 49442
Muskegon County (616) 685-3098

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 Borton's NPI number?

The NPI number for Benjamin Borton is 1740799451. It was assigned to this individual provider in the NPPES registry on September 26, 2017.

Where is Benjamin Borton located?

Benjamin Borton practices at 1675 Leahy St Ste 215A, Muskegon, MI 49442. The listed phone number is (616) 685-3098.

What is Benjamin Borton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Benjamin Borton enrolled in Medicare?

Yes. Benjamin Borton 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.

What insurance does Benjamin Borton accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Benjamin Borton 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 Borton affiliated with any hospitals?

According to CMS data, Benjamin Borton is affiliated with Mercy Health Saint Mary's and Trinity Health Muskegon Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Borton was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.