DR. JAMES VAUGHAN M.D. NPI 1003019860

Pathology (Anatomic Pathology & Clinical Pathology) in Milwaukee, WI

NPI 1003019860 Individual Male Years of Experience 15 Pathology Anatomic Pathology & Clinical Pathology PECOS Enrolled Accepts Medicare Approved Payment

About JAMES VAUGHAN

James Vaughan is a provider established in Milwaukee, Wisconsin and his medical specialization is pathology (anatomic pathology & clinical pathology) with more than 15 years of experience. He graduated from University Of Texas Southwestern Medical School At Dallas in 2007. The NPI number of James Vaughan is 1003019860 and was assigned on June 2007. The practitioner's primary taxonomy code is 207ZP0102X with license number 48735 (TN). The provider is registered as an individual and his NPI record was last updated 2 years ago.

James Vaughan is enrolled in PECOS and is eligible to order or refer healthcare 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

James Vaughan is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with University Of Tn Medical Center.

NPI

1003019860

Provider NameDR. JAMES VAUGHAN M.D.
Provider Location Address8701 W WATERTOWN PLANK RD MILWAUKEE, WI 53226
Provider Mailing Address315A N 71ST ST WAUWATOSA, WI 53213
GenderMale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduation Year2007
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date06-08-2007
Last Update Date09-17-2019


Primary Taxonomy

Taxonomy Code207ZP0102X
ClassificationPathology
TypeAllopathic & Osteopathic Physicians
SpecializationAnatomic Pathology & Clinical Pathology
License No.48735
License StateTN
Taxonomy DescriptionA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Business Address

DR. JAMES VAUGHAN M.D.
8701 W WATERTOWN PLANK RD
MILWAUKEE, WI
ZIP 53226
Phone: (414) 456-8296

Get Directions


Mailing Address

DR. JAMES VAUGHAN M.D.
315A N 71ST ST
WAUWATOSA, WI
ZIP 53213
Phone: (214) 533-4830



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID6608023585
PECOS Enrollment IDI20120828000768
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 572Special stained specimen slides to examine tissue (HCPCS:88341)
  • 340Tissue or cell analysis by immunologic technique (HCPCS:88342)
  • 127Pathology examination of tissue using a microscope, moderately high complexity (HCPCS:88307)
  • 85Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • 68Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. James Vaughan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UNIVERSITY OF TN MEDICAL CENTER1924 ALCOA HIGHWAY
KNOXVILLE, TN 37920
(865) 544-9000Acute Care Hospitals440015

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659320331 ROBERT J. VICKREY M.D.
Individual
Psychiatry & Neurology (Psychiatry)8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-8990
1841371234DR. KHAZI A MUQEET M.D
Individual
Psychiatry & Neurology (Psychiatry)8701 W WATERTOWN PLANK RD DEPT OF PYCHIATRY
MILWAUKEE, WI 53226
(414) 456-6000
1134208192DR. ANITA VIJAYAKUMAR MD
Individual
General Practice8701 W WATERTOWN PLANK RD MEDICAL COLLEGE OF WISCONSIN DEPARTMENT OF PSYCHIATRY
MILWAUKEE, WI 53226
(414) 456-8900
1295802254DR. DAVID CHUNG M.D.
Individual
Psychiatry & Neurology (Psychiatry)8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-6000
1861533770 MARY F RAYNOR NP
Individual
Nurse Practitioner8701 W WATERTOWN PLANK RD DIVISION OF NEOPLASTIC DISEASES
MILWAUKEE, WI 53226
(414) 805-4600
1699894675 ANGELA SCHARNHORST M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
WAUWATOSA, WI 53226
(262) 570-2760
1891901112DR. DAVIDA A. ROBINSON M.D.
Individual
Surgery8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-8296
1326243718 MARK CHRISTIAN PHELPS M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(800) 465-3203
1154501500DR. OLUGBENGA B KUTEYI MD, FWACP.
Individual
Psychiatric Unit8701 W WATERTOWN PLANK RD MCWAH
MILWAUKEE, WI 53226
(414) 266-3736
1659545465 ASHA MEHTA
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-4574
1700032059DR. MARIO LUC MD
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-4575
1821230483DR. ROBERT JOSEPH ZIMMANCK M.D.
Individual
Anesthesiology8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 805-3000
1699918573MS. STACY KAISER MD
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(210) 771-7077
1245473701DR. RONE CHUN LIN M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-4575
1356575500MR. KAUSTUBH PRADIP SAGDEO MD
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 456-8296
1629202577 DARIA ZORZI M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD POST OFFICE BOX 26509
MILWAUKEE, WI 53226
(414) 456-4575
1801027602DR. SURAJ PAL SINGH M.D.,MRCPSYCH
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD POST OFFICE BOX 266509
MILWAUKEE, WI 53226
(414) 456-4575
1710298575DR. JOHN JEFFREY FISZER M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD POST OFFICE BOX 26509
MILWAUKEE, WI 53226
(414) 456-4575
1134418080 RAHA NABBI M.D.
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 955-4578
1578852315MRS. KRISTIN BUCKNER JAKUBOWSKI
Individual
Student in an Organized Health Care Education/Training Program8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226
(414) 955-4575

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.