DR. JAMES GEORGE DROUGAS M.D.
NPI 1013912914
Surgery in Roanoke, VA

NPI Status: Active since June 16, 2005

Contact Information

1234 FRANKLIN RD SW
ROANOKE, VA
ZIP 24016
Phone: (540) 345-1561
Fax: (540) 345-2112

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Surgery
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About JAMES DROUGAS

This page provides the complete NPI Profile along with additional information for James Drougas, a provider established in Roanoke, Virginia with a medical specialization in Surgery. The healthcare provider is registered in the NPI registry with number 1013912914 assigned on June 2005. The practitioner's primary taxonomy code is 208600000X with license number 0101055612 (VA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI: 1013912914
Provider Name: DR. JAMES GEORGE DROUGAS M.D.
Gender: Male
Entity Type: Individual
Location Address: 1234 FRANKLIN RD SW ROANOKE, VA 24016
Location Phone: (540) 345-1561
Location Fax: (540) 345-2112
Mailing Address: 213 S JEFFERSON ST STE 1006 ROANOKE, VA 24011
Is Sole Proprietor?: No
Enumeration Date: 06-16-2005
Last Update Date: 07-04-2024
Code Navigator

A surgeon like James Drougas treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

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: Surgery
Taxonomy Code: 208600000X
Type: Allopathic & Osteopathic Physicians
License No.: 0101055612
License State: VA
Taxonomy Description: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	174400000X	Other Service Providers	Specialist	0101055612 (VA)
2	2086S0129X	Allopathic & Osteopathic Physicians	Surgery Vascular Surgery	0101055612 (VA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
007311176	MEDICAID (05)	VA

Medicare Participation & PECOS Enrollment Status

James Drougas is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

James Drougas 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
PECOS PAC ID: 1951571660
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20110906000621
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
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 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complete ultrasound of abdomen and pelvis artery and vein blood flow
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fluoroscopic guidance for insertion or removal of central vein access device
Follow-up hospital inpatient care per day, typically 15 minutes
Fusion of lower spine bone through abdomen with partial removal of disc
Fusion of spine bones through front of body with partial removal of disc, each additional disc
Hernia repair - groin (open)
Initial hospital inpatient care per day, typically 50 minutes
Injection of chemical agent into multiple incompetent veins of leg
Insertion of cage or mesh device to spine bone and disc space during spine fusion
Insertion of tunneled central venous tube for infusion (5 years or older)
Laser destruction of incompetent vein of arm or leg using imaging guidance
Leg revascularization (restoring blood flow)
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 45-59 minutes
Placement of stabilizing device to front, 2-3 spine bone segments
Removal of blood clot and portion of chest, neck, or brain artery
Spinal fusion
Strapping, unna boot
Ultrasonic guidance for blood vessel access
Ultrasound of both sides of head and neck blood flow
Ultrasound of hemodialysis access
Ultrasound of leg arteries or artery grafts
Ultrasound of one leg arteries or artery grafts
Ultrasound of one side of head and neck blood flow
Ultrasound study of arm and leg arteries
Ultrasound study of arm or leg veins with compression and maneuvers
Ultrasound study of one arm or leg veins with compression and maneuvers
Varicose vein removal

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.72 for a new patient copayment and $17.52 for an established patient copayment.

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 24016 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $86.88
Minimum New Patient Price $56.19
Maximum New Patient Price $170.3

Average New Patient Copayment $21.72
Minimum New Patient Copayment $14.04
Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $70.08
Minimum Established Patient Price $18.07
Maximum Established Patient Price $138.91

Average Established Patient Copayment $17.52
Minimum Established Patient Copayment $4.51
Maximum Established Patient Copayment $34.72

* 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
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Colorectal Cancer Screening	60%	820
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Consultation of the Prescription Drug Monitoring Program	Yes	N/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Coronary Artery Disease (CAD): Antiplatelet Therapy	7%	75
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing	97%	107
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	56%	106
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.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation	94%	484
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	95%	1418
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.
Pneumococcal Vaccination Status for Older Adults	77%	800
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	100%	697
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization	57%	781
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	14%	1237
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	95%	1418
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	1%	1418
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 High-Risk Medications in the Elderly	1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	800
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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 Drougas is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type
CARILION MEDICAL CENTER	1906 BELLEVIEW AVENUE, SE ROANOKE, VA 24014	(540) 981-7000	Acute Care Hospitals
CARILION NEW RIVER VALLEY MEDICAL CENTER	2900 LAMB CIRCLE CHRISTIANSBURG, VA 24073	(540) 731-2000	Acute Care Hospitals
CARILION FRANKLIN MEMORIAL HOSPITAL	180 FLOYD AVENUE ROCKY MOUNT, VA 24151	(540) 483-5277	Acute Care Hospitals

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1013912914, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 9 → 18 → 9 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 1 + 8 + 1 + 4 + 9 + 2 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4

This NPI is valid

The calculated check digit is 4, which matches the last digit of 1013912914.