DR. JAMES G THEURER MD
NPI 1083685101
Ophthalmology in Provo, UT

Active since January 27, 2006PECOS EnrolledAccepts Medicare Assignment
85.09/100
CMS Quality Rating
1735 N STATE ST, PROVO, UT 84604(801) 374-1818(801) 379-2959 Get Directions Write a Review

NPPES record last updated: September 16, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. James G Theurer Md NPPES

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

DR. JAMES G THEURER MD (NPI 1083685101) is an individual ophthalmology provider in Provo, Utah, licensed in Utah (983624541205) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Utah School Of Medicine (1994).

NPPES Registry Identity

NPI1083685101
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. JAMES G THEURERCredential: MD
Location Address1735 N STATE STProvo, UT 84604-1010
Mailing Address120 S 1025 ELindon, UT 84042-2134 · (801) 362-3151
Fax(801) 379-2959
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 1994
Enumeration DateJanuary 27, 2006
Last NPPES UpdateSeptember 16, 2011
NPI 1083685101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in UT · 983624541205
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1735 N STATE ST, Provo, UT 84604

Other Identifiers 12

Other87028357684604A001UT · Tricare
Other0800084UT · United Healthcare
Other107008469102UT · Select Health
Other5557665UT · Aetna
Medicare UPING45568UT
Other345610UT · Dmba
Other8064710002UT · Cigna
Other1182764UT · Affordable
Other180041850UT · Railroad Medicare
Other87028357684604A001UT · Pgba
Other870283576TH1UT · Emia
Medicare ID-Type Unspecified005504404UT

Accepted 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

Dr. James G Theurer Md 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 ID1254355274
PECOS Enrollment IDI20060118000042
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 12

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
617 services462 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
231 services224 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.
209 services129 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
193 services172 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
170 services119 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
153 services151 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

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.

85.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality99.31
Improvement Activities40
Cost51.57

Reported Quality Measures

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
100%62 patients5/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 19

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

Ophthalmology (Retina Specialist)
1735 N STATE ST
PROVO, UT 84604
Ophthalmology
1735 N STATE ST
PROVO, UT 84604
Ophthalmology
1735 N STATE ST
PROVO, UT 84604
Ophthalmology
1735 N STATE ST
PROVO, UT 84604
Ophthalmology
1735 N STATE ST
PROVO, UT 84604
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
1735 N STATE ST
PROVO, UT 84604
Eyewear Supplier
1735 N STATE ST
PROVO, UT 84604
Ophthalmology (Cornea and External Diseases Specialist)
1735 N STATE ST
PROVO, UT 84604

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 Theurer's NPI number?

The NPI number for James Theurer is 1083685101. It was assigned to this individual provider in the NPPES registry on January 27, 2006.

Where is James Theurer located?

James Theurer practices at 1735 N State St, Provo, UT 84604. The listed phone number is (801) 374-1818.

What is James Theurer's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is James Theurer enrolled in Medicare?

Yes. James Theurer 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 Theurer accept?

Health plans from Imperial Health Plan of the Southwest, Inc. list James Theurer 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 Theurer was last updated on September 16, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.