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DR. BENJAMIN LEE HENSLEY D.O.
NPI 1932303682
Surgery in Summersville, WV

Active since June 14, 2007PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651(304) 872-5124(304) 872-0409 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 21, 2022, Aug 6, 2021, Jan 13, 2021 (3 updates tracked since 2021).

About Dr. Benjamin Lee Hensley D.o. NPPES

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

DR. BENJAMIN LEE HENSLEY D.O. (NPI 1932303682) is an individual surgery provider in Summersville, West Virginia, licensed in West Virginia (2403) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with United Hospital Center, Inc, and is a graduate of West Virginia School Of Osteopathic Medicine (2004).

NPPES Registry Identity

NPI1932303682
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. BENJAMIN LEE HENSLEYCredential: D.O.
Location Address400 FAIRVIEW HEIGHTS RDSummersville, WV 26651-9308
Mailing Address400 Fairview Heights RdSummersville, WV 26651-9308 · (304) 872-5124 · Fax (304) 872-0409
Phone(304) 872-5124
Fax(304) 872-0409
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2004
Enumeration DateJune 14, 2007
Last NPPES UpdateApril 21, 20223 updates tracked since enumeration
NPPES CertifiedApril 21, 2022
✔ NPI 1932303682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in WV · 2403
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
400 FAIRVIEW HEIGHTS RD, Summersville, WV 26651
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Dr. Benjamin Lee Hensley D.o. 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 ID6507910817
PECOS Enrollment IDI20090821000066
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 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 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.
32 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
24 services24 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
17 services17 patients
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.
14 services13 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.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

United Hospital Center, Inc

Acute Care Hospitals · Bridgeport, WV
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510006
Location327 Medical Park DriveBridgeport, WV 26330 · Harrison County
Emergency services Birthing friendly

Braxton County Memorial Hospital, Inc

Critical Access Hospitals · Gassaway, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511308
Location100 Hoylman DriveGassaway, WV 26624 · Braxton County
Emergency services

Summersville Regional Medical Center

Critical Access Hospitals · Summersville, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511322
Location400 Fairview Heights RoadSummersville, WV 26651 · Nicholas County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26651 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
97%205 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
98%276 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.

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.

AMIT KAUSHAL M.D
Internal Medicine
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-8601
BANDY B MULLINS MD
Surgery
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-8404
WEST VIRGINIA HEALTH CARE COOPERATIVE INC
General Acute Care Hospital (Critical Access)
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-8402
SUMMERSVILLE REGIONAL MEDICAL CENTER
General Acute Care Hospital (Critical Access)
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-2891
NICHOLAS EMERGENCY GROUP, PLLC
Emergency Medicine
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-2891
SUMMERSVILLE PEDIATRICS INC.
Specialist
400 FAIRVIEW HEIGHTS RD, SUITE 302
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-7063
DR. RACHEL DAVIS PHARMD
Pharmacist
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-8437
SUMMERSVILLE REGIONAL MEDICAL CENTER
Nursing Facility/Intermediate Care Facility
400 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV 26651
Nicholas County (304) 872-2891

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 Hensley's NPI number?

The NPI number for Benjamin Hensley is 1932303682. It was assigned to this individual provider in the NPPES registry on June 14, 2007.

Where is Benjamin Hensley located?

Benjamin Hensley practices at 400 Fairview Heights Rd, Summersville, WV 26651. The listed phone number is (304) 872-5124.

What is Benjamin Hensley's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Benjamin Hensley enrolled in Medicare?

Yes. Benjamin Hensley 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 Hensley accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Benjamin Hensley 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 Hensley affiliated with any hospitals?

According to CMS data, Benjamin Hensley is affiliated with United Hospital Center, Inc, Braxton County Memorial Hospital, Inc and Summersville Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Benjamin Hensley was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.