OLIVER JAMES BENES M.D.
NPI 1972742963
Preventive Medicine - Addiction Medicine in Covington, KY

Q: What is Oliver Benes's NPI number?

The NPI number for Oliver Benes is 1972742963. It was assigned to this individual provider in the NPPES registry on February 13, 2009.

Q: What is Oliver Benes's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Addiction Medicine, with taxonomy code 2083A0300X.

Q: When was this NPI record last updated?

The NPPES record for Oliver Benes was last updated on February 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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 February 13, 2009PECOS EnrolledAccepts Medicare Assignment

90.38/100

CMS Quality Rating

20 W 18TH ST, COVINGTON, KY 41011(859) 757-0717(859) 331-2425 Get Directions Write a Review

NPPES record last updated: February 26, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 26, 2025, Nov 8, 2023, Feb 22, 2021 and 3 more (6 updates tracked since 2016).

On this page

About Oliver James Benes M.d. NPPES

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

OLIVER JAMES BENES M.D. (NPI 1972742963) is an individual addiction medicine provider in Covington, Kentucky, licensed in Kentucky (42910) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1972742963

Entity TypeIndividualMale

Primary Taxonomy2083A0300X

Provider Legal NameOLIVER JAMES BENESCredential: M.D.

Location Address20 W 18TH STCovington, KY 41011-3329

Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 371-1153 · Fax (859) 647-5113

Phone(859) 757-0717

Fax(859) 331-2425

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateFebruary 13, 2009

Last NPPES UpdateFebruary 26, 20256 updates tracked since enumeration

NPPES CertifiedFebruary 26, 2025

✔ NPI 1972742963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083A0300X

Licenses✔ Licensed in KY · 42910✔ Licensed in IN · 01089064A

Definition

A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 42910 (KY)

20 W 18TH ST, Covington, KY 41011

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Other Identifiers 1

Medicaid7100153650KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health 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

Oliver James Benes 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 ID9638352354

PECOS Enrollment IDI20110317000610, I20250308000145

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.

Hospital Affiliations CMS Care Compare

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

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41011 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

90.38/100

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

Scored through an Alternative Payment Model

Quality

80.76

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

73%70 patients3/55-star benchmark: 100%

Medication Reconciliation Post-Discharge

The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…

100%23 patients

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

86%111 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…

22%153 patients1/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

34%119 patients2/55-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 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers25 claims38 services$4.69 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

4 suppliers20 claims20 services$57.13 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$31.74 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 12

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

ANDREW F ARTHUR LMFT

Marriage & Family Therapist