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JAMES M. SMITH M.D.
NPI 1053395129
Hospitalist in Newnan, GA

Active since December 02, 2005PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
2401 NEWNAN CROSSING BLVD E, SUITE 200, NEWNAN, GA 30265(770) 400-7700 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About James M. Smith M.d. NPPES

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

JAMES M. SMITH M.D. (NPI 1053395129) is an individual hospitalist provider in Newnan, Georgia, licensed in Georgia (022644) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and is a graduate of Medical College Of Georgia School Of Medicine (1979).

NPPES Registry Identity

NPI1053395129
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameJAMES M. SMITHCredential: M.D.
Location Address2401 NEWNAN CROSSING BLVD E, SUITE 200Newnan, GA 30265-2408
Mailing Address2401 Newnan Crossing Blvd E, Suite 200Newnan, GA 30265-2408 · (770) 400-7700
Phone(770) 400-7700
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1979
Enumeration DateDecember 2, 2005
Last NPPES UpdateMarch 22, 2017
✔ NPI 1053395129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in GA · 022644
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 022644 (GA)
2401 NEWNAN CROSSING BLVD E, Newnan, GA 30265
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Other Identifiers 2

Medicare UPIND91023GA
Medicaid00244373AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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 M. Smith M.d. 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 ID5597750430
PECOS Enrollment IDI20040623000288
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 10

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
1,165 services419 patients
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.
880 services407 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.
149 services121 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
148 services117 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
39 services39 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
38 services18 patients

Hospital Affiliations CMS Care Compare 3

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

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110083
Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County
Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110215
Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County
Emergency services Birthing friendly

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110229
Location745 Poplar RoadNewnan, GA 30265 · Coweta County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30265 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
19%615 patients1/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
64%22 patients3/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
72%330 patients3/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
36%105 patients1/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 98% · 93 patients
98%99 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
94%617 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
94%649 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
83%541 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
83%245 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
21 suppliers94 claims186 services$5.20 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers15 claims21 services$0.94 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers11 claims22 services$1.25 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers11 claims11 services$90.23 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers11 claims32 services$34.33 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers11 claims11 services$61.09 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 6

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

CENTER FOR PAIN AND SPINE, LLC
Clinic/Center (Ambulatory Surgical)
2401 NEWNAN CROSSING BLVD E, SUITE 130
NEWNAN, GA 30265
Coweta County (678) 794-2106
AYESHA AFSAR FARUQI
Internal Medicine
2401 NEWNAN CROSSING BLVD E, SUITE 200
NEWNAN, GA 30265
Coweta County (770) 400-7700
WILLIAM SCOTT ALEXANDER, MD, LLC
Emergency Medicine (Undersea and Hyperbaric Medicine)
2401 NEWNAN CROSSING BLVD E
NEWNAN, GA 30265
Coweta County (678) 662-2617
STANLEY W. SMITH M.D.
Hospitalist
2401 NEWNAN CROSSING BLVD E, SUITE 200
NEWNAN, GA 30265
Coweta County (770) 400-7700
DR. ERIKA MARTINEZ-URIBE M.D.
Internal Medicine
2401 NEWNAN CROSSING BLVD E
NEWNAN, GA 30265
Coweta County (770) 400-7700
DR. KIM JACKSON MATHEWS DMD
Dentist (Pediatric Dentistry)
2401 NEWNAN CROSSING BLVD E, SUITE 210
NEWNAN, GA 30265
Coweta County (770) 251-5777

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 Smith's NPI number?

The NPI number for James Smith is 1053395129. It was assigned to this individual provider in the NPPES registry on December 2, 2005.

Where is James Smith located?

James Smith practices at 2401 Newnan Crossing Blvd E Suite 200, Newnan, GA 30265. The listed phone number is (770) 400-7700.

What is James Smith's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is James Smith enrolled in Medicare?

Yes. James Smith 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 Smith accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list James Smith 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 Smith affiliated with any hospitals?

According to CMS data, James Smith is affiliated with Piedmont Hospital, Piedmont Fayette Hospital and Piedmont Newnan Hospital, Inc.

When was this NPI record last updated?

The NPPES record for James Smith was last updated on March 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.