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DR. JAMES HENRY MCQUISTON D.O.
NPI 1053302091
Surgery in Macomb Township, MI

Active since October 31, 2005PECOS EnrolledAccepts Medicare Assignment
17375 HALL RD, MACOMB TOWNSHIP, MI 48044(586) 228-0550(586) 228-8125 Get Directions Write a Review

NPPES record last updated: January 21, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. James Henry Mcquiston D.o. NPPES

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

DR. JAMES HENRY MCQUISTON D.O. (NPI 1053302091) is an individual surgery provider in Macomb Township, Michigan, licensed in Michigan (5101008641) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Mclaren Macomb, and is a graduate of Michigan State University College Of Osteopathic Medicine (1983).

NPPES Registry Identity

NPI1053302091
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. JAMES HENRY MCQUISTONCredential: D.O.
Location Address17375 HALL RDMacomb Township, MI 48044-4060
Mailing Address17375 Hall RdMacomb Township, MI 48044-4060 · (586) 228-0550 · Fax (586) 228-8125
Phone(586) 228-0550
Fax(586) 228-8125
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1983
Enumeration DateOctober 31, 2005
Last NPPES UpdateJanuary 21, 2015
✔ NPI 1053302091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MI · 5101008641
Definition
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.
17375 HALL RD, Macomb Township, MI 48044
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Other Identifiers 3

Medicaid1912266MI
Medicare UPINE26124MI
Medicare PIN0N87470MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Henry Mcquiston D.o. 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 ID2163410606
PECOS Enrollment IDI20040511001377
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.

Medicare Billing Reassignments

4

Medicare enrollment records show James Mcquiston reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northeast Surgical Group PC
Same address
Surgery
17375 HALL RD
Macomb, MI 48044
  • Reassigned Medicare billing, Michigan enrollment
  • 3 clinicians in this Medicare group
NPI 1700984200 (586) 228-0550
Mclaren Macomb
3.8 mi
Nurse Anesthetist, Certified Registered
1000 HARRINGTON ST
Mount Clemens, MI 48043
  • Reassigned Medicare billing, Michigan enrollment
  • 188 clinicians in this Medicare group
NPI 1528002532 (586) 493-8747
Regional Trauma Care PC
3.8 mi
Surgery
1000 HARRINGTON ST, TRAUMA SERVICES
Mount Clemens, MI 48043
  • Reassigned Medicare billing, Michigan enrollment
  • 10 clinicians in this Medicare group
NPI 1851554497 (586) 493-3814
Mclaren Medical Group
35 mi
Diagnostic Radiology
1254 N MAIN ST
Lapeer, MI 48446
  • Reassigned Medicare billing, Michigan enrollment
  • 416 clinicians in this Medicare group
NPI 1073650750 (810) 664-4531

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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 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.
94 services50 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
93 services40 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
31 services21 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
29 services29 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
28 services27 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mclaren Macomb

Acute Care Hospitals · Mount Clemens, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230227
Location1000 Harrington StMount Clemens, MI 48043 · Macomb County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48044 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

DR. KARI A HORTOS D.O.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
17375 HALL RD
MACOMB TOWNSHIP, MI 48044
Macomb County (586) 228-0550
CORIE LOUISE SEELBACH
Surgery
17375 HALL RD
MACOMB, MI 48044
Macomb County (586) 228-0550
DR. MICHAEL JUDE D'ALMEIDA D.O.
Surgery
17375 HALL RD
MACOMB TOWNSHIP, MI 48044
Macomb County (586) 228-0550
NORTHEAST SURGICAL GROUP PC
Surgery
17375 HALL RD
MACOMB, MI 48044
Macomb County (586) 228-0550
DR. DOUGLAS GORDON PAULK D.O.
Surgery
17375 HALL RD
MACOMB TOWNSHIP, MI 48044
Macomb County (586) 228-0550
DR. ROY EUGENE HANKS II D.O.
Surgery
17375 HALL RD
MACOMB TOWNSHIP, MI 48044
Macomb County (586) 228-0550

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 Mcquiston's NPI number?

The NPI number for James Mcquiston is 1053302091. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is James Mcquiston located?

James Mcquiston practices at 17375 Hall Rd, Macomb Township, MI 48044. The listed phone number is (586) 228-0550.

What is James Mcquiston's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is James Mcquiston enrolled in Medicare?

Yes. James Mcquiston 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.

Which organizations bill Medicare for James Mcquiston's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Mcquiston reassigns Medicare benefits to 4 organizations: Northeast Surgical Group PC (Macomb, MI), Mclaren Macomb (Mount Clemens, MI), Regional Trauma Care PC (Mount Clemens, MI) and Mclaren Medical Group (Lapeer, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Mcquiston's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Mcquiston accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list James Mcquiston 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.

Is James Mcquiston affiliated with any hospitals?

According to CMS data, James Mcquiston is affiliated with Mclaren Macomb.

When was this NPI record last updated?

The NPPES record for James Mcquiston was last updated on January 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.