BENJAMIN MICHAEL CAPLAN PA-C
NPI 1881260990
Physician Assistant in Du Bois, PA

Active since May 29, 2021PECOS EnrolledAccepts Medicare Assignment
96.56/100
CMS Quality Rating
204 HOSPITAL AVE, DU BOIS, PA 15801(814) 371-2200 Get Directions Write a Review

NPPES record last updated: October 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 8, 2021, Jun 7, 2021, May 29, 2021 (3 updates tracked since 2021).

About Benjamin Michael Caplan Pa-c NPPES

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

BENJAMIN MICHAEL CAPLAN PA-C (NPI 1881260990) is an individual physician assistant in Du Bois, Pennsylvania, licensed in Pennsylvania (OA005700) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Huntingdon, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1881260990
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBENJAMIN MICHAEL CAPLANCredential: PA-C
Location Address204 HOSPITAL AVEDu Bois, PA 15801-1442
Mailing Address2752 Drake CtGibsonia, PA 15044-8374 · (412) 849-3321
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateMay 29, 2021
Last NPPES UpdateOctober 8, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2021
NPI 1881260990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in PA · OA005700
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

204 HOSPITAL AVE, Du Bois, PA 15801

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Michael Caplan Pa-c 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 ID2567851058
PECOS Enrollment IDI20211123001767
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 5

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
73 services60 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.
44 services43 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.
39 services39 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.
37 services27 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
15 services15 patients

Hospital Affiliations CMS Care Compare 5

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

Penn Highlands Huntingdon

Acute Care Hospitals · Huntingdon, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390056
Location1225 Warm Springs AveHuntingdon, PA 16652 · Huntingdon County
Emergency services

Penn Highlands Dubois

Acute Care Hospitals · Dubois, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390086
Location100 Hospital AvenueDubois, PA 15801 · Clearfield County

Clarion Hospital

Acute Care Hospitals · Clarion, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390093
LocationOne Hospital DriveClarion, PA 16214 · Clarion County
Emergency services

Penn Highlands Brookville

Critical Access Hospitals · Brookville, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391312
Location100 Hospital RoadBrookville, PA 15825 · Jefferson County
Emergency services

Penn Highlands Elk

Critical Access Hospitals · Saint Marys, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number391315
Location763 Johnsonburg RoadSaint Marys, PA 15857 · Elk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15801 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

96.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability95.96
Improvement Activities40

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.

Community Health Worker
204 HOSPITAL AVE
DU BOIS, PA 15801
Student in an Organized Health Care Education/Training Program
204 HOSPITAL AVE
DU BOIS, PA 15801

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881260990, enumerated as an "individual" on May 29, 2021.

The provider is located at 204 HOSPITAL AVE DU BOIS, PA 15801 and the phone number is (814) 371-2200.

Physician Assistant with taxonomy code 363A00000X.

Benjamin Caplan is affiliated with: PENN HIGHLANDS HUNTINGDON, PENN HIGHLANDS DUBOIS, CLARION HOSPITAL, PENN HIGHLANDS BROOKVILLE and PENN HIGHLANDS ELK.