Benjamin J Moreno (NPI# 1013163526, PAC ID# 4789862228) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1013163526 |
| PAC ID by PECOS | 4789862228 |
| Professional Enrollment ID | I20110701000238 |
| Full Name | Benjamin J Moreno |
| Organization Legal Name | FORT WAYNE RADIOLOGY ASSOCIATES LLC |
| Address |
2200 Randallia Dr Fort Wayne IN 46805-4638 |
| Phone Number | 2603734000 |
| Gender | M |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 2005 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY |
| Group Practice PAC ID | 5294624060 |
| Number of Group Practice Members | 31 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150021 | PARKVIEW REGIONAL MEDICAL CENTER |
| 151315 | CAMERON MEMORIAL COMMUNITY HOSPITAL INC |
| 360121 | COMMUNITY HOSPITALS AND WELLNESS CENTERS |
| 150101 | PARKVIEW WHITLEY HOSPITAL |
| 150091 | PARKVIEW HUNTINGTON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 121 Westfield Dr, Archbold, OH 43502-1056 | 4194454415 | FORT WAYNE RADIOLOGY ASSOCIATES LLC |
| 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2603734000 | FORT WAYNE RADIOLOGY ASSOCIATES LLC |
| 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2609691124 | FORT WAYNE RADIOLOGY ASSOCIATES LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_021_overall | Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin | 35% | |
| MIPS_EC_021_overall | Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin | 35% | |
| MIPS_EC_023_overall | Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) | 3% | |
| MIPS_EC_023_overall | Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) | 3% | |
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 61% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 61% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 82% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 82% |
| Organization Legal Name | FORT WAYNE RADIOLOGY ASSOCIATES LLC |
| Physicians | 30 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adam Michael Gregory | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 1355 Mariners Dr, Warsaw, IN 46582-7145 |
| Christopher Michael Wing | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 1260 E State Rd, Suite 205, Columbia City, IN 46725-9492 |
| Melissa Sue Bosma | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 433 W High St, Bryan, OH 43506-1679 |
| William Cohee Petty | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Matthew W Hasselman | Physician Assistant | Fort Wayne Radiology Associates LLC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Brad M Johnston | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Mitchell E Travis | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 |
| David Keith Powell | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 416 E Maumee St, Angola, IN 46703-2015 |
| Ronald J Douglas | Physician Assistant | Fort Wayne Radiology Associates LLC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Tram Schroeder | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 |
| Street Address |
2200 RANDALLIA DR |
| City | FORT WAYNE |
| State | IN |
| Zip | 46805-4638 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danyelle R Aber | Emergency Medicine | Professional Emergency Physicians PC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Betsy G Krause | Family Medicine | Professional Emergency Physicians PC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Vatche Israbian | Pulmonary Disease | Parkview Health System Inc | 2200 Randallia Dr, Fort Wayne, IN 46805-4699 |
| Mckenna Renee Brauner | Physician Assistant | Parkview Health System Inc | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Jaime R Hajjari | Emergency Medicine | Professional Emergency Physicians PC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Kevin L Murphy | Psychiatry | Parkview Health System Inc | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Nicholas J Gould | Emergency Medicine | Professional Emergency Physicians PC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Samantha Raffieed | Physician Assistant | Parkview Health System Inc | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| William Cohee Petty | Diagnostic Radiology | Fort Wayne Radiology Associates LLC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Justin S. Ritonya | Emergency Medicine | Professional Emergency Physicians PC | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alicia R Swank | Optometry | Midwest Eye Consultants PC | 431 W Coliseum, Fort Wayne, IN 46805-1010 |
| Joseph M Mattox | Family Medicine | Parkview Ortho Performance Center LLC | 3946 Ice Way, Parkview Ortho Performance Center, Fort Wayne, IN 46805-1018 |
| Jodi L Chambers | Physician Assistant | Parkview Ortho Performance Center LLC | 3946 Ice Way, Parkview Ortho Performance Center, Fort Wayne, IN 46805-1018 |
| Zubair A Khan | Optometry | Fort Wayne Vision Associates Ltd | 515 E Coliseum Blvd, Fort Wayne, IN 46805-1215 |
| Prevesh K Rustagi | Psychiatry | 3400 E Coliseum Blvd, Suite 340, Fort Wayne, IN 46805-1656 | |
| Syed M Sohail | Internal Medicine | Fort Wayne Medical Clinic PC | 3411 N Anthony Blvd, Suite 2, Fort Wayne, IN 46805-2233 |
| Aaron Christopher Frey | Optometry | Frey Vision Group of Indiana Inc | 3409 N Anthony Blvd, Fort Wayne, IN 46805-2233 |
| Myra R Weber | Optometry | Frey Vision Group of Indiana Inc | 3409 N Anthony Blvd, Fort Wayne, IN 46805-2233 |
| David S Millay | Optometry | Frey Vision Group of Indiana Inc | 3409 N Anthony Blvd, Fort Wayne, IN 46805-2233 |
| Emma Shoemaker | Optometry | Frey Vision Group of Indiana Inc | 3409 N Anthony Blvd, Fort Wayne, IN 46805-2233 |
| Find all physicians in zip 46805 | |||
| City | FORT WAYNE |
| Zip Code | 46805 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | FORT WAYNE + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.