BENJAMIN THOMAS HEATWOLE M.D.
NPI 1871819128
Hospitalist in Winfield, IL

Q: What is Benjamin Heatwole's NPI number?

The NPI number for Benjamin Heatwole is 1871819128. It was assigned to this individual provider in the NPPES registry on April 12, 2010.

Q: What is Benjamin Heatwole's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Heatwole was last updated on May 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 April 12, 2010PECOS EnrolledAccepts Medicare Assignment

96.84/100

CMS Quality Rating

25 N WINFIELD RD, 400, WINFIELD, IL 60190(630) 456-7178 Get Directions Write a Review

NPPES record last updated: May 2, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Benjamin Thomas Heatwole M.d. NPPES

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

BENJAMIN THOMAS HEATWOLE M.D. (NPI 1871819128) is an individual hospitalist provider in Winfield, Illinois, licensed in Illinois (036132531) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Lowell General Hospital, and is a graduate of Pennsylvania State University College Of Medicine (2010).

NPPES Registry Identity

NPI1871819128

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameBENJAMIN THOMAS HEATWOLECredential: M.D.

Location Address25 N WINFIELD RD, 400Winfield, IL 60190

Mailing Address1860 Paysphere CirChicago, IL 60674-0018

Phone(630) 456-7178

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 2010

Enumeration DateApril 12, 2010

Last NPPES UpdateMay 2, 2019

✔ NPI 1871819128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in IL · 036132531

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 036132531 (IL)

25 N WINFIELD RD, Winfield, IL 60190

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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 Thomas Heatwole 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 ID2163664616

PECOS Enrollment IDI20210415001746

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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

690 services349 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.

189 services186 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.

116 services115 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.

107 services95 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.

35 services35 patients

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.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Lowell General Hospital

Acute Care Hospitals · Lowell, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220063

Location295 Varnum AvenueLowell, MA 01854 · Middlesex County

Emergency services Birthing friendly

Winchester Hospital

Acute Care Hospitals · Winchester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220105

Location41 Highland AvenueWinchester, MA 01890 · Middlesex County

Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220171

Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60190 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

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

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.

96.84/100

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

Individually scored

Quality

94.14

Improvement Activities

Cost

78.74

Reported Quality Measures

Advance Care Plan

97%183 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

98%55 patients4/55-star benchmark: 100%

Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

90%40 patients3/55-star benchmark: 100%

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

95%40 patients4/55-star benchmark: 100%

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 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 suppliers12 claims12 services$14.89 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 suppliers14 claims14 services$68.17 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.

JOSEPH RAYMOND SCHNEIDER MD

Surgery (Vascular Surgery)

25 N WINFIELD RD, SUITE 201
WINFIELD, IL 60190

Dupage County (630) 933-4487

JESSICA LASAK BERNARDI APN

Nurse Practitioner