DR. JAMES ARTHUR ENGBLOM DPM NPI 1053398107
Podiatrist in Oak Ridge, TN

About DR. JAMES ARTHUR ENGBLOM DPM

James Engblom is a provider established in Oak Ridge, Tennessee and his medical specialization is Podiatrist with more than 36 years of experience. He graduated from Temple University School Of Podiatric Medicine in 1987. The NPI number of James Engblom is 1053398107 and was assigned on December 2005. The practitioner's primary taxonomy code is 213E00000X with license number DPM338 (TN). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1053398107
Provider NameDR. JAMES ARTHUR ENGBLOM DPM
Location Address90 VERMONT AVE SUITE 300 OAK RIDGE, TN 37830
Location Phone(865) 481-2541
Mailing Address256 FORT SANDERS WEST BLVD KNOXVILLE, TN 37922
GenderMale
NPI Entity TypeIndividual
Medical School NameTEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year1987
Is Sole Proprietor?No
Enumeration Date12-29-2005
Last Update Date06-02-2016

A podiatrist like Dr. James Arthur Engblom Dpm provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.James Engblom 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) and a Home Health Agency (HHA).

James Engblom 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 Methodist Medical Center Of Oak Ridge and Roane Medical Center.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 87.2, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.08 for a new patient copayment and $17.19 for an established patient copayment.



Primary Taxonomy

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.

Taxonomy Code213E00000X
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
License No.DPM338
License StateTN
Taxonomy DescriptionA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Blue Cross Blue Shield
  • Medicaid
  • Medicare
  • Railroad Medicare

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

Business Address

DR. JAMES ARTHUR ENGBLOM DPM
90 VERMONT AVE
SUITE 300
OAK RIDGE, TN
ZIP 37830
Phone: (865) 481-2541

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Mailing Address

DR. JAMES ARTHUR ENGBLOM DPM
256 FORT SANDERS WEST BLVD
KNOXVILLE, TN
ZIP 37922
Phone: (865) 769-4500
Fax: (865) 769-4572


Location Map

PECOS Enrollment and Medicare Participation Status

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.

Registered in PECOS? Yes
PECOS PAC ID6507875382
PECOS Enrollment IDI20060406000581
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 DevicesNo

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 37830 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$54.58 $167.19 $84.32
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.64 $41.79 $21.08
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.86 $136.82 $68.78
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.21 $34.2 $17.19

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 56
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% 77.4
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 87.2
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

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.

  • 191X-ray of foot, minimum of 3 views (HCPCS:73630)
  • 52Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • 24Injections of tendon sheath, ligament, or muscle membrane (HCPCS:20550)
  • 20Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • 15Removal of tissue from wounds per session (HCPCS:97597)

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
480026064OTHER (01)TNRAILROAD MEDICARE
3711776MEDICARE PIN (08)TN
T97948MEDICARE UPIN (02)
6035392OTHER (01)TNBCBS TN
3351783MEDICAID (05)TN
0677340009MEDICARE NSC (07)TN

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1053398107
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20103691610
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 0 + 3 + 6 + 9 + 1 + 6 + 1 + 0 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1053398107 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1912991837 SCOTT LLOYD BAER OD
Individual
Optometrist90 VERMONT AVE THE EYE CENTER OF OAK RIDGE PC
OAK RIDGE, TN 37830
(865) 482-8890
1083608905 LEE ALAN SMALLEY MD
Individual
Ophthalmology90 VERMONT AVE THE EYE CENTER OF OAK RIDGE PC
OAK RIDGE, TN 37830
(865) 482-8890
1699769521 JAMES EDWARD KUNEMAN OD
Individual
Optometrist90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1609860386 ROBERT EARL WALKER MD
Individual
Ophthalmology90 VERMONT AVE THE EYE CENTER OF OAK RIDGE PC
OAK RIDGE, TN 37830
(865) 482-8890
1508850298 BRADLEY JOHNSON LUTTRELL MD
Individual
Ophthalmology90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1861486573 TIMOTHY PAUL POWERS MD
Individual
Ophthalmology90 VERMONT AVE THE EYE CENTER OF OAK RIDGE PC
OAK RIDGE, TN 37830
(865) 482-8890
1669449658DR. CLIFFORD LEWIS POSMAN M.D.
Individual
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 481-2541
1649351479 KATHRYN RENEE BAKER MD
Individual
Ophthalmology90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1619090370DR. THOMAS LLOYD DAHL JR. M.D.
Individual
Ophthalmology90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1164655205DR. NATALIE LYNN FRASIER O.D.
Individual
Optometrist90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8900
1972635910 ERIC EDWARD SPECKNER M.D.
Individual
Ophthalmology90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1235201393EYE CENTER OF OAK RIDGE,PC
Organization
Ophthalmology90 VERMONT AVE
OAK RIDGE, TN 37830
(865) 482-8890
1275623522ORTHOTENNESSEE, PC
Organization
Durable Medical Equipment & Medical Supplies90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 482-9025
1366533127ORTHOTENNESSEE, PC
Organization
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 482-9025
1467547125ORTHOTENNESSEE, PC
Organization
Clinic/Center (Physical Therapy)90 VERMONT AVE SUITE 301
OAK RIDGE, TN 37830
(865) 482-2390
1710955315DR. MICHAEL ALAN MACKAY M.D.
Individual
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 481-2541
1285602953DR. CLETUS J. MCMAHON JR. M.D.
Individual
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 481-2541
1528037710DR. MICHAEL PATRICK O'BRIEN M.D.
Individual
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 481-2541
1003044033 CHARLES DANIEL BENSON MD
Individual
Orthopaedic Surgery90 VERMONT AVE SUITE 300
OAK RIDGE, TN 37830
(865) 482-9025
1518086396 WILLIAM F ROBINSON P.T.
Individual
Physical Therapist90 VERMONT AVE SUITE 301
OAK RIDGE, TN 37830
(865) 482-2390

Frequently Asked Questions

What is Dr. James Engblom DPM NPI number?

The NPI number assigned to Dr. James Engblom DPM is 1053398107, registered as an "individual" on December 29, 2005

Where is Dr. James Engblom DPM located?

The provider is located at 90 Vermont Ave Suite 300 Oak Ridge, Tn 37830 and the phone number is (865) 481-2541

Which is Dr. James Engblom DPM specialty?

The provider's speciality is Podiatrist

How many years of experience does Dr. James Engblom DPM have?

The provider has more than 36 years of experience. He graduated from Temple University School Of Podiatric Medicine in 1987.

What insurance does Dr. James Engblom DPM accept?

The provider might be accepting Blue Cross Blue Shield, Medicaid, Medicare and Railroad Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. James Engblom DPM registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

How much is a visit to Dr. James Engblom DPM?

Medicare beneficiaries should expect a typical cost of $84.32 with an average copayment of $21.08 for new patient appointments. Established patients should expect a typical charge of $68.78 and an average copayment of 17.19. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. James Engblom DPM?

The most common procedures or services performed by this practitioner are: X-ray of foot, minimum of 3 views, Removal of skin and tissue first 20 sq cm or less, Injections of tendon sheath, ligament, or muscle membrane, Injection, methylprednisolone acetate, 40 mg and Removal of tissue from wounds per session.

How do I update my NPI information?

The NPI record of Dr. James Engblom DPM was last updated on December 29, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]