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Deactivated NPI 1477696870 Deactivated / Inactive NPI Male Practitioner

Dr. Benjamin T Jackson , MD

Surgery • Providence, RI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Benjamin Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 15, 2007
NPI Deactivation Date August 10, 2017
Total Practice Duration ~10 Years of Practice (2007 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Jackson, MD was a registered Surgery practicing in Providence, RI. Throughout an active medical career spanning 10 years, Dr. Jackson provided care at the practice location at PROVIDENCE VA MEDICAL CENTER until profile deactivation on 2017-08-10.

Practice Location & Contact Primary Location

Practice Address

Providence Va Medical Center
Davis Park

Providence, RI 02908

Telephone 4014573043

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.5 Yrs
State Avg: 29.0 Yrs
Regional Practice Density
95 Specialists

Practicing in Providence, RI (160 Statewide)

Telehealth Adoption Rate
4.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MA 28325

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Richard Synnott , MSW

Social Worker - Clinical

NPI 1295754141

Master of Social Work

Dr. Amal Trivedi , MD

Internal Medicine

NPI 1396825576

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 10, 2017

Record deactivated on August 10, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at PROVIDENCE VA MEDICAL CENTER, DAVIS PARK, PROVIDENCE, RI 02908 (Tel: 4014573043)

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Updated Business Mailing Address July 08, 2007

Registered at 11 OCTOBER LN, WESTON, MA 024931724 (Tel: 4014573043)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BENJAMIN JACKSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #28325 in MA)

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Initial NPI Registration & Enumeration February 15, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477696870
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2007
Last Update: July 08, 2007
Deactivation Date: August 10, 2017

Mailing Address

11 October Ln

Weston, MA 024931724

Phone: 4014573043

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.