MR. JAMES L TOUGAS AG-NP
NPI 1073991477
Nurse Practitioner - Gerontology in Fenton, MI

Q: What is James Tougas's NPI number?

The NPI number for James Tougas is 1073991477. It was assigned to this individual provider in the NPPES registry on May 18, 2015.

Q: What is James Tougas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for James Tougas was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since May 18, 2015PECOS EnrolledAccepts Medicare Assignment

8323 MABLEY HILL RD, UNITED STATES, FENTON, MI 48430(248) 387-9196 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 28, 2026, Mar 5, 2026, Jul 12, 2023 (3 updates tracked since 2023).

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About Mr. James L Tougas Ag-np NPPES

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

MR. JAMES L TOUGAS AG-NP (NPI 1073991477) is an individual gerontology provider in Fenton, Michigan, licensed in Michigan (4704250106) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, maintains a secondary practice location in Roseburg, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1073991477

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameMR. JAMES L TOUGASCredential: AG-NP

Location Address8323 MABLEY HILL RD, UNITED STATESFenton, MI 48430-9455

Mailing Address8323 Mabley Hill Rd, United StatesFenton, MI 48430-9455 · (734) 444-9858 · Fax (810) 202-7410

Phone(248) 387-9196

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateMay 18, 2015

Last NPPES UpdateApril 28, 20263 updates tracked since enumeration

NPPES CertifiedApril 28, 2026

✔ NPI 1073991477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MI · 4704250106

Also ListedNurse PractitionerTaxonomy 363L00000X · License 11024811 (MI)

8323 MABLEY HILL RD, Fenton, MI 48430

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Secondary Practice Location 1

Location 11221 W Harvard AveRoseburg, OR 97471-2836 · Phone (541) 357-8346 · Fax (541) 833-0857

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

Mr. James L Tougas Ag-np 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 ID2466768916

PECOS Enrollment IDI20150831000568, I20230406000884

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

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

Home MD PLLC

18 mi

Adult Medicine

4568 W WALTON BLVD STE D
Waterford, MI 48329

Reassigned Medicare billing, Michigan enrollment

NPI 1407747215 (855) 466-3631

Transitional Care Services, LLC

18 mi

Gerontology

4568 W WALTON BLVD STE D
Waterford, MI 48329

Reassigned Medicare billing, Michigan enrollment
72 clinicians in this Medicare group

NPI 1174976807 (855) 466-3631

Sciometrix LLC

34 mi

General Practice

306 S WASHINGTON AVE STE 600
Royal Oak, MI 48067

Reassigned Medicare billing, Michigan enrollment
97 clinicians in this Medicare group

NPI 1619649894 (860) 335-5064

M. E. Mateo, MD, PLLC

35 mi

Family Medicine

1106 E 11 MILE RD
Royal Oak, MI 48067

Reassigned Medicare billing, Michigan enrollment
3 clinicians in this Medicare group

NPI 1114731924 (917) 373-1886

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 23

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.

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

2,087 services154 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

1,001 services155 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

647 services118 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

639 services340 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

526 services163 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

370 services225 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

369 services237 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

348 services173 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

141 services134 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

79 services59 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

73 services73 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

46 services40 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

43 services41 patients

Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347

An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.

39 services39 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

37 services32 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

35 services35 patients

Trimming of fingernails or toenails 11719

Trimming of fingernails or toenails is a simple procedure for maintaining hygiene and preventing nail-related issues. It involves cutting the nails straight across, then smoothing any sharp edges with a file. Regular nail care can help prevent infections and discomfort.

34 services34 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

30 services30 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

27 services27 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

26 services22 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

25 services24 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

20 services20 patients

Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes 99345

A new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.

20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48430 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Reported Quality Measures

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…

12%25 patients1/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

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

22%79 patients2/55-star benchmark: 88%

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 2

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

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers14 claims14 services$4.70 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers23 claims23 services$186.55 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

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

MRS. STEPHANIE REED PT

Physical Therapist

8323 MABLEY HILL RD
FENTON, MI 48430

Genesee County (248) 387-9196

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 Tougas's NPI number?

The NPI number for James Tougas is 1073991477. It was assigned to this individual provider in the NPPES registry on May 18, 2015.

Where is James Tougas located?

James Tougas practices at 8323 Mabley Hill Rd United States, Fenton, MI 48430. The listed phone number is (248) 387-9196.

What is James Tougas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is James Tougas enrolled in Medicare?

Yes. James Tougas 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 Tougas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Tougas reassigns Medicare benefits to 4 organizations: Home MD PLLC (Waterford, MI), Transitional Care Services, LLC (Waterford, MI), Sciometrix LLC (Royal Oak, MI) and M. E. Mateo, MD, PLLC (Royal Oak, 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 Tougas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Tougas 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 3 other insurers list James Tougas 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 Tougas was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.