BENJAMIN NEAL GILBERT MD
NPI 1811930118
Ophthalmology in Chico, CA

Active since June 14, 2006PECOS EnrolledAccepts Medicare Assignment
98.71/100
CMS Quality Rating
3401 ESPLANADE, CHICO, CA 95973(530) 895-1727(530) 895-1506 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 25, 2023, Mar 7, 2023, Jul 1, 2016 (3 updates tracked since 2016).

About Benjamin Neal Gilbert Md NPPES

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

BENJAMIN NEAL GILBERT MD (NPI 1811930118) is an individual ophthalmology provider in Chico, California, licensed in California (G85718) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Georgetown University School Of Medicine (1989).

NPPES Registry Identity

NPI1811930118
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameBENJAMIN NEAL GILBERTCredential: MD
Location Address3401 ESPLANADEChico, CA 95973-0207
Mailing Address3401 EsplanadeChico, CA 95973-0207 · (530) 895-1727 · Fax (530) 895-1506
Fax(530) 895-1506
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 1989
Enumeration DateJune 14, 2006
Last NPPES UpdateJuly 25, 20233 updates tracked since enumeration
NPPES CertifiedDecember 21, 2022
NPI 1811930118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in CA · G85718
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
3401 ESPLANADE, Chico, CA 95973

Other Identifiers 1

Medicaid00G857180CA

Accepted 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 Neal Gilbert 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 ID9436229804
PECOS Enrollment IDI20090624000434
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 24

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.
1,241 services1,042 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.
796 services498 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
478 services441 patients
Microfluid analysis of tears 83861
Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
348 services172 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
330 services327 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
241 services237 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95973 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
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.

98.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.69
Improvement Activities40
Cost97.45

Referred Medical Equipment & Supplies CMS DME claims

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

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
3 suppliers11 claims11 services$67.48 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 7

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

Ophthalmology
3401 ESPLANADE
CHICO, CA 95973
Ophthalmology
3401 ESPLANADE
CHICO, CA 95973
Optometrist
3401 ESPLANADE
CHICO, CA 95973
Ophthalmology
3401 ESPLANADE
CHICO, CA 95973
Optometrist
3401 ESPLANADE
CHICO, CA 95973
Ophthalmology
3401 ESPLANADE
CHICO, CA 95973
Optometrist
3401 ESPLANADE
CHICO, CA 95973

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 Gilbert's NPI number?

The NPI number for Benjamin Gilbert is 1811930118. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is Benjamin Gilbert located?

Benjamin Gilbert practices at 3401 Esplanade, Chico, CA 95973. The listed phone number is (530) 895-1727.

What is Benjamin Gilbert's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Benjamin Gilbert enrolled in Medicare?

Yes. Benjamin Gilbert 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 Gilbert accept?

Health plans from Providence Health Plan list Benjamin Gilbert 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.

When was this NPI record last updated?

The NPPES record for Benjamin Gilbert was last updated on July 25, 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.