DR. LORENA BENAVIDES M.D.
NPI 1053375949
Obstetrics & Gynecology - Gynecology in Raleigh, NC
NPI Status: Active since April 17, 2006
Contact Information
2304 WESVILL CT
SUITE 210
RALEIGH, NC
ZIP 27607
Phone: (919) 782-6700
Fax: (919) 782-2218
- Individual
- Female
- Obstetrics & Gynecology
- Gynecology
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
- Medicare Quality Reporting
About LORENA BENAVIDES
This page provides the complete NPI Profile along with additional information for Lorena Benavides, a women's health care provider established in Raleigh, North Carolina with a medical specialization in Obstetrics & Gynecology, focusing in gynecology . The healthcare provider is registered in the NPI registry with number 1053375949 assigned on April 2006. The practitioner's primary taxonomy code is 207VG0400X with license number 2006-00441 (NC). The provider is registered as an individual and her NPI record was last updated 9 years ago.
- NPI
- 1053375949
- Provider Name
- DR. LORENA BENAVIDES M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607
- Location Phone
- (919) 782-6700
- Location Fax
- (919) 782-2218
- Mailing Address
- 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607
- Mailing Phone
- (919) 782-6700
- Mailing Fax
- (919) 782-2218
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-17-2006
- Last Update Date
- 08-17-2016
- Code Navigator
Women's health care providers like Lorena Benavides treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Lorena Benavides opted out of Medicare effective on 04-01-2019 until 04-01-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology Gynecology
- Taxonomy Code
- 207VG0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2006-00441
- License State
- NC
- Taxonomy Description
- A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard | Nationwide Doctors - PPO
- Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Standard | Statewide Doctors - HMO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Gold CMS Standard - HMO
- Connect Silver 3500 Indiv Med Deductible - HMO
- Connect Silver 4400 Indiv Med Deductible - HMO
- Connect Silver CMS Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
- WellCare Secure Health Bronze - PPO
- WellCare Secure Health Gold - PPO
- WellCare Secure Health Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Lorena Benavides is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2019
Opt-Out End Date: 04-01-2025
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 27607 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $125.01
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $31.25
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.72
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $16.93
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| e-Prescribing | 97% | 2343 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 15% | 142 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 855 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 17% | 4333 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 96% | 4333 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 61% | 4333 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 5 | 3 | 3 | 7 | 5 | 9 | 4 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 10 | 3 | 6 | 7 | 10 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 0 + 3 + 6 + 7 + 1 + 0 + 9 + 8 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1053375949 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1336108299 | DR. HUBERT BENBURY HAYWOOD III M.D. Individual | Internal Medicine (Infectious Disease) | 2304 WESVILL CT SUITE 240 RALEIGH, NC 27607 (919) 571-1567 |
| 1659324648 | AESTHETIC & RECONSTRUCTIVE PLASTIC SURGERY,PLLC Organization | Specialist | 2304 WESVILL CT # 360 RALEIGH, NC 27607 (919) 785-1220 |
| 1326115502 | DR. LYNDA R HEYMEN PSYD Individual | Psychologist | 2304 WESVILL CT SUITE 280 RALEIGH, NC 27607 (919) 786-9799 |
| 1073794921 | DR. GLENN M DAVIS MD Individual | Specialist | 2304 WESVILL CT # 360 RALEIGH, NC 27607 (919) 785-1220 |
| 1538410683 | DIANE S TILLEY FNP-BC Individual | Nurse Practitioner (Family) | 2304 WESVILL CT SUITE 240 RALEIGH, NC 27607 (919) 571-1567 |
| 1245410901 | DR. JEREMY W PYLE M.D. Individual | Plastic Surgery | 2304 WESVILL CT SUITE 360 RALEIGH, NC 27607 (919) 785-1220 |
| 1770541658 | MS. JANICE MARIE ALEXANDER TAYLOR CNM, MN Individual | Obstetrics & Gynecology (Gynecology) | 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607 (919) 782-6700 |
| 1003839937 | RALEIGH GYNECOLOGY & WELLNESS PA Organization | Obstetrics & Gynecology | 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607 (919) 782-6700 |
| 1669474268 | MRS. LAURIE MAY MARSTON MD Individual | Obstetrics & Gynecology (Obstetrics) | 2304 WESVILL CT STE 210 RALEIGH, NC 27607 (919) 782-6700 |
| 1760603492 | DR. SUZANNE BUKREY KAMINSKI M.D. Individual | Obstetrics & Gynecology (Gynecology) | 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607 (919) 782-6700 |
| 1861680928 | DR. BENJAMIN CHADWICK WOOD M.D. Individual | Surgery (Plastic and Reconstructive Surgery) | 2304 WESVILL CT SUITE 360 RALEIGH, NC 27607 (919) 785-1220 |
| 1114958204 | CAROLINA RADIOLOGY PA Organization | Radiology (Diagnostic Radiology) | 2304 WESVILL CT SUITE 110 RALEIGH, NC 27607 (919) 614-0906 |
| 1477586469 | PRIVATE DIAGNOSTIC CLINIC, PLLC Organization | Internal Medicine | 2304 WESVILL CT SUITE 210 RALEIGH, NC 27607 (919) 684-8111 |
| 1497431837 | WAKEMED SPECIALISTS GROUP, LLC Organization | Internal Medicine (Infectious Disease) | 2304 WESVILL CT RALEIGH, NC 27607 (919) 350-8000 |
| 1821429572 | MRS. LAURIE RANCIK HOGAN NP Individual | Nurse Practitioner (Adult Health) | 2304 WESVILL CT STE 240 RALEIGH, NC 27607 (919) 571-1567 |
| 1881205276 | TERRI LEWELLEN ROBINSON PA-C Individual | Physician Assistant | 2304 WESVILL CT RALEIGH, NC 27607 (919) 571-1567 |
| 1962464719 | PAUL ROBERT BECHERER M.D. Individual | Internal Medicine (Infectious Disease) | 2304 WESVILL CT SUITE 240 RALEIGH, NC 27607 (919) 571-1567 |
| 1023342938 | DR. NISHA THANNIKKARY MANICKAM DO Individual | Internal Medicine (Infectious Disease) | 2304 WESVILL CT RALEIGH, NC 27607 (919) 235-1802 |
| 1063721223 | MR. JOHN ANDREW BULLINGTON JR. RN, ANP Individual | Nurse Practitioner (Adult Health) | 2304 WESVILL CT SUITE 240 RALEIGH, NC 27607 (919) 235-1802 |
| 1215179247 | JAY CHRISTOPHER SELLERS M.D. Individual | Internal Medicine (Infectious Disease) | 2304 WESVILL CT RALEIGH, NC 27607 (919) 235-1802 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053375949, enumerated in the NPI registry as an "individual" on April 17, 2006
The provider is located at 2304 Wesvill Ct Suite 210 Raleigh, Nc 27607 and the phone number is (919) 782-6700
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207VG0400X with a focus in Gynecology
The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $125.01 with an average copayment of $31.25 for new patient appointments. Established patients should expect a typical charge of $67.72 and an average copayment of 16.93. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on April 01, 2019 to opt-out of the Medicare program. The provider is excluded from the Medicare program until April 01, 2025.
This NPI record was last updated on April 17, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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