BENJAMIN P ROOSE (M.D.) – Surgery Physician, NPI 1609286509
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
Provider Addresses for BENJAMIN P ROOSE (M.D.)
1105 SIXTH ST
TRAVERSE CITY, MI 496842386
Phone:
Type: Mailing
927 S CARMEL ST
CADILLAC, MI 496012547
Phone: (231) 876-3876
Fax: (231) 775-1115
Type: Location
1345 E Parkdale Ave
Manistee, MI 496609318
Phone: (231) 398-1740
Type: Location
829 N Center Ave Ste 120
Gaylord, MI 497351598
Phone: (989) 731-7987
Type: Location
PO BOX 3988
CARBONDALE, IL 629023988
Phone: (618) 457-5200
Type: Mailing
220 S PARK AVE FL 3
HERRIN, IL 62948
Phone: (618) 942-2002
Fax: (618) 351-6497
Type: Location
220 S Park Ave Fl 3
Herrin, IL 62948
Phone: (618) 942-2002
Fax: (618) 351-6497
Type: Location
1100 E Michigan Ave
Grayling, MI 497381312
Phone: (989) 348-5461
Fax: (989) 348-5724
Type: Location
825 N Center Ave
Gaylord, MI 497351592
Phone: (989) 731-7996
Fax: (989) 731-9151
Type: Location
14700 Lake Shore Dr
Charlevoix, MI 497201999
Phone: (231) 547-4024
Fax: (231) 547-8088
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-04-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191004001807 | I | General Surgery | IL | TBD |
| I20240208002610 | I | General Surgery | MI | TBD |
| I20250403003283 | I | General Surgery | WY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49684)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| O T O L A R Y N G O L O G Y | NC | |
| Family Practice | NV | |
| Family Practice | WY | |
| General Surgery | WY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WY | |
| - | WY | |
| Internal Medicine, Sleep Medicine | CA | |
| - | WY | |
| - | WY | |
| Family Practice | WY |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.