2026 NPPES data Hospitalist Physician NPI 1194958942
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BENJAMIN HELMS

Hospitalist Physician in KNOXVILLE, Tennessee. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
157
Medicare Part D claims · 62 beneficiaries · Hospitalist Physician avg: 888
Generic prescribing
83%
generic claims · 17% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.6914/100
▲ 13 pts above national avg 83.1 · [object Object]
Industry payments
$95.25
5 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: BENJAMIN HELMS is a Hospitalist Physician ([object Object]) practicing in KNOXVILLE, Tennessee with a Medicare Part D prescribing footprint of 157 claims across 62 beneficiaries — 17% brand-name prescribing . Their CMS MIPS Final Score of 95.6914/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $95.25 across 5 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: BENJAMIN HELMS reported a CMS MIPS final score of 95.6914 out of 100, above the 83.1 national average, and filed 157 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

BENJAMIN HELMS practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

BENJAMIN HELMS at a glance

High performer (top quartile)

NPI registry status

Active

Issued 08/27/2009

NPI 1194958942

Primary specialty

Hospitalist Physician

Mid-sized

16,825 US NPIs in this specialty

Medicare Part D claims

157 82% vs specialty avg

2023 prescription claims

Specialty avg: 888

MIPS final score

95.6914/100 12.591400000000007% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Tennessee

How Hospitalist Physician compares to other specialties among Tennessee providers

Tennessee providers

Hospitalist Physician share within Tennessee

1. Hospitalist Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Hospitalist Physician share within Tennessee

Medicare quality performance — MIPS

BENJAMIN HELMS's 2023 MIPS final score plotted against the Hospitalist Physician national average

High performer (top quartile)
MIPS Final Score
95.6914/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Hospitalist Physician) — 95.6914/100 vs national avg 83.1

0%100%National avg83%95.7%
MIPS final score (Hospitalist Physician) — 95.6914/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

BENJAMIN HELMS is a Hospitalist Physician provider practicing in KNOXVILLE, Tennessee, according to the CMS National Plan and Provider Enumeration System (NPPES). NPI: 1194958942. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

BENJAMIN HELMS appears in the CMS NPPES registry as a Hospitalist Physician provider at 1924 ALCOA HWY, KNOXVILLE, TN, 37920, with a listed phone of (865) 305-9081. NPI 1194958942 was issued on 08/27/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what HELMS most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 157 prescription claims written by this provider, covering 62 Medicare beneficiaries and totaling roughly $13K in drug spend, split 17% brand-name and 83% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 95.6914/100 for the 2023 performance year (Quality 85.2885), compared with the national average of 83.1.

Hospitalist Physician is a mid-sized specialty nationwide, with 16,825 enrolled providers across 54 states and an average of 888 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

1924 ALCOA HWY
KNOXVILLE, TN 37920

Provider Details

NPI 1194958942
Specialty Hospitalist Physician
Gender Male
NPI Issued 08/27/2009

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

95.6914
Final Score
Avg: 83.1
85.2885
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where BENJAMIN HELMS bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

UNIVERSITY HEALTH SYSTEM, INC.
KNOXVILLE, TN

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for BENJAMIN HELMS. Source: openpaymentsdata.cms.gov.

Total received

$95

Largest payer

PFIZER INC.

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

Brand vs generic prescribing mix · Typical

BENJAMIN HELMS — brand share 17.0%
Specialty average (est.)

17% brand-name claims vs 83% generic, on 157 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

157
Total Claims
$13K
Total Drug Cost
62
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
188
Total Day Supply
4,025
Brand vs Generic
17% brand / 83% generic
Brand Drug Cost
$11K
Generic Drug Cost
$2K
Antibiotic Claims
34

Patient Demographics

Average Patient Age
72.0 years
Avg HCC Risk Score
2.80
Gender Split
60% female / 40% male

Hospitalist Physician Overview

How BENJAMIN HELMS fits within the Hospitalist Physician landscape nationally.

16,825
Hospitalist Physician Providers in US
54
States with Hospitalist Physician
888
Avg Claims per Provider

BENJAMIN HELMS's 157 claims are below the specialty average of 888.

Nearby Hospitalist Physician Providers in Tennessee

Other clinicians with the same primary specialty enrolled in Tennessee, drawn from the same CMS NPPES roster as HELMS.

Compare Hospitalist Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is BENJAMIN HELMS's specialty?
BENJAMIN HELMS specializes in Hospitalist Physician and practices in KNOXVILLE, Tennessee.
How much does BENJAMIN HELMS prescribe under Medicare Part D?
In 2023, BENJAMIN HELMS wrote 157 Medicare Part D claims totaling $13K in drug costs for 62 beneficiaries.
What is BENJAMIN HELMS's Medicare quality score?
BENJAMIN HELMS has a CMS MIPS Final Score of 95.6914/100 (Quality: 85.2885). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is BENJAMIN HELMS located?
BENJAMIN HELMS is located at 1924 ALCOA HWY, KNOXVILLE, TN, 37920. Phone: (865) 305-9081.
What is BENJAMIN HELMS's NPI number?
BENJAMIN HELMS's National Provider Identifier (NPI) is 1194958942, issued on 08/27/2009.
Does BENJAMIN HELMS prescribe more brand-name or generic drugs?
BENJAMIN HELMS's prescribing is 17% brand-name and 83% generic drugs by claim count, with $11K in brand drug costs.
How many Hospitalist Physician providers are there in the US?
There are 16,825 Hospitalist Physician providers across 54 states in the US. The average Hospitalist Physician provider writes 888 Medicare Part D claims per year.
Does BENJAMIN HELMS accept Medicare?
BENJAMIN HELMS appears in CMS Medicare data with 157 Part D claims and 62 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify BENJAMIN HELMS's credentials?
BENJAMIN HELMS's NPI is 1194958942. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology