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JAMES TOMKINSON MD
NPI 1013413814
Pediatrics - Sleep Medicine in Leesburg, VA

Active since April 02, 2018PECOS EnrolledAccepts Medicare Assignment
92.61/100
CMS Quality Rating
19441 GOLF VISTA PLZ STE 310, LEESBURG, VA 20176(703) 729-3420(703) 729-3422 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 10, 2025, Aug 12, 2025, Oct 18, 2023 and 3 more (6 updates tracked since 2021).

About James Tomkinson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES TOMKINSON MD (NPI 1013413814) is an individual sleep medicine provider in Leesburg, Virginia, licensed in Virginia (0101278005) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Virginia Commonwealth University, School Of Medicine (2018).

NPPES Registry Identity

NPI1013413814
Entity TypeIndividualMale
Primary Taxonomy2080S0012X
Provider Legal NameJAMES TOMKINSONCredential: MD
Location Address19441 GOLF VISTA PLZ STE 310Leesburg, VA 20176-8272
Mailing AddressPo Box 3250Winchester, VA 22604-2450 · (703) 673-4490 · Fax (540) 678-9025
Phone(703) 729-3420
Fax(703) 729-3422
Sole ProprietorNo
Medical School CMSVirginia Commonwealth University, School Of MedicineGraduated 2018
Enumeration DateApril 2, 2018
Last NPPES UpdateOctober 10, 20256 updates tracked since enumeration
NPPES CertifiedOctober 10, 2025
✔ NPI 1013413814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080S0012X
Licenses✔ Licensed in VA · 0101278005✔ Licensed in MD · D0097288
Definition
A Pediatrician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
19441 GOLF VISTA PLZ STE 310, Leesburg, VA 20176
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Other Identifiers 2

Medicaid1013413814VA
Medicaid30017644230001VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Tomkinson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163816901
PECOS Enrollment IDI20230711004170, I20230712002616
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
186 services137 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
52 services52 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
47 services45 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
40 services40 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20176 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.22
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers12 claims50 services$1.83 avg. paid by Medicare
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
3 suppliers23 claims24 services$87.69 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
2 suppliers17 claims18 services$11.70 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HWAN KIM M.D.
Internal Medicine (Sleep Medicine)
19441 GOLF VISTA PLZ STE 310
LEESBURG, VA 20176
Loudoun County (703) 729-3420
SHAHRIAR SHAHZEIDI MD
Pediatrics (Sleep Medicine)
19441 GOLF VISTA PLZ STE 310
LEESBURG, VA 20176
Loudoun County (703) 729-3420
DR. SEAN D ROTOLO MD
Psychiatry & Neurology (Sleep Medicine)
19441 GOLF VISTA PLZ STE 310
LEESBURG, VA 20176
Loudoun County (703) 729-3420
DR. CHARU SABHARWAL MD
Internal Medicine (Sleep Medicine)
19441 GOLF VISTA PLZ STE 310
LEESBURG, VA 20176
Loudoun County (703) 729-3420

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Tomkinson's NPI number?

The NPI number for James Tomkinson is 1013413814. It was assigned to this individual provider in the NPPES registry on April 2, 2018.

Where is James Tomkinson located?

James Tomkinson practices at 19441 Golf Vista Plz Ste 310, Leesburg, VA 20176. The listed phone number is (703) 729-3420.

What is James Tomkinson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sleep Medicine, with taxonomy code 2080S0012X.

Is James Tomkinson enrolled in Medicare?

Yes. James Tomkinson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does James Tomkinson accept?

Health plans from Oscar Insurance Company list James Tomkinson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Tomkinson was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.