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    OpenPayerNPI Medicare & MedicaidBenjamin Proto
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    Benjamin Proto — Billing Profile & Reimbursement Data

    NPI 1073506291 · Newport News, VA · Podiatrist

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    Benjamin Proto is a podiatrist provider located in Newport News, Virginia. This profile covers 28 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationBenjamin Proto
    Address860 Omni Blvd
    CityNewport News
    StateVA
    ZIP23606
    TaxonomyPodiatrist
    NPI EnumeratedAugust 23, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$218.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    28 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…660$70$42.7K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…390$90$35.7K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…250$80$19K
    73630In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.710$30$17.6K
    15738The provider creates a muscle, myocutaneous, or fasciocutaneous flap from a lower extremity of the patient to treat injury or open wounds on an affected area.20$920$15.6K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…140$120$15.6K
    20604In this procedure, the provider inserts a needle through the skin of a patient and into a small joint or bursa, typically the fingers or toes, and then uses the syringe attachment to the needle to…190$50$9.7K
    28750In this procedure, the provider surgically immobilizes the metatarsophalangeal joint of the great toe. A metatarsophalangeal joint is a joint between the first metatarsal of the foot and the first…20$420$9.3K
    11750The provider removes part or all of a fingernail or toenail, including the nail plate and matrix and including the lunula if the excision is complete.70$120$8K
    28285The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.30$160$5.1K

    Showing 1–10 of 28

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    28 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    2875062020$1,380$24.9K
    992142,75612,890140$80$21K
    1573821020$980$16.7K
    28285194030$410$14.5K
    17110446530120$80$13.7K
    9921349612,44090$60$10K
    1104223227080$70$9.6K
    28308122020$340$7.4K
    992044506,85040$110$5.9K
    2827221030$210$5K

    Showing 1–10 of 28

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Benjamin Proto, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tidewater Physicians Multispecialty Group PCVAFamily Medicine Physician$0$5.9M
    Kristi MizelleVARheumatology Physician$1.5M$0
    Ivan Marchena- MendezPARheumatology Physician$1M$0
    Michael GenVAInterventional Cardiology Physician$705.1K$0
    Audra AlbertVAFamily Nurse Practitioner$639.8K$0
    Aleisha JohnsonVADiagnostic Radiology Physician$626.6K$0
    Pranav ParikhVAInternal Medicine Physician$579K$0
    Jeffrey VandesandVADiagnostic Radiology Physician$550.4K$0
    Matthew DohertyVADiagnostic Ultrasound Physician$540.2K$0
    Stephen CummingsVAOrthopaedic Surgery Physician$493.5K$0

    Nearby Providers

    Other providers in the same ZIP code as Benjamin Proto, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    National Counseling Group, IncVAMental Health Counselor$0$25.9M
    Maxim Healthcare Services, Inc.VAHome Health Agency$0$20M
    Care Advantage, IncVAHome Health Agency$0$17.4M
    Behavior Health & Wellness Center, LLCVABehavior Analyst$0$15.8M
    Personal Touch Home Care Of Va, IncVAHome Health Agency$0$14.6M
    Odyssey Community Services IncVACommunity/Behavioral Health Agency$0$14.4M
    Hope In-home Care LLCVAHome Health Agency$0$10.2M
    1life1love, Inc.VACommunity/Behavioral Health Agency$0$9.2M
    Beyond Disabilities, LLCVADevelopmentally Disabled Services Day Training Agency$0$7.9M
    Childrens Medical Group IncVAPediatrics Physician$0$7.1M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Benjamin Proto — 5 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia