JAMES MATTHEW ROUSE M.D.
NPI 1083877369
Ophthalmology in Knoxville, TN

Q: What is James Rouse's NPI number?

The NPI number for James Rouse is 1083877369. It was assigned to this individual provider in the NPPES registry on July 7, 2008.

Q: What is James Rouse's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for James Rouse was last updated on January 31, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 07, 2008PECOS EnrolledAccepts Medicare Assignment

47.96/100

CMS Quality Rating

1932 ALCOA HWY STE 255, KNOXVILLE, TN 37920(865) 244-2030(865) 684-1196 Get Directions Write a Review

NPPES record last updated: January 31, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About James Matthew Rouse M.d. NPPES

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

JAMES MATTHEW ROUSE M.D. (NPI 1083877369) is an individual ophthalmology provider in Knoxville, Tennessee, licensed in Tennessee (046957) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2006).

NPPES Registry Identity

NPI1083877369

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameJAMES MATTHEW ROUSECredential: M.D.

Location Address1932 ALCOA HWY STE 255Knoxville, TN 37920-1508

Mailing Address1932 Alcoa Hwy Ste 255Knoxville, TN 37920-1508 · (865) 244-2030 · Fax (865) 684-1196

Phone(865) 244-2030

Fax(865) 684-1196

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2006

Enumeration DateJuly 7, 2008

Last NPPES UpdateJanuary 31, 2019

✔ NPI 1083877369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in TN · 046957

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.

1932 ALCOA HWY STE 255, Knoxville, TN 37920

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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 Matthew Rouse 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 ID4486822533

PECOS Enrollment IDI20110718000114

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 18

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.

776 services753 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.

732 services556 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).

571 services560 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month 99426

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

504 services129 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

467 services456 patients

Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month 99427

Principal Care Management (PCM) services focus on managing a single high-risk disease. It involves additional 30 minutes of clinical staff time per month, overseen by a healthcare professional. This includes monitoring your health, coordinating care, and developing a personalized treatment plan.

230 services100 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.

173 services149 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

166 services108 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

159 services100 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

123 services121 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

78 services78 patients

Dilation of fluid outflow drainage within eye 66174

Dilation to improve eye fluid flow is a process where eye drops are used to widen or dilate your pupils. This allows more fluid to flow out of the eye, reducing pressure and helping to prevent or treat conditions like glaucoma.

53 services38 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

51 services51 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

35 services27 patients

Insertion of eye fluid drainage device 66183

The insertion of an eye fluid drainage device is a procedure to manage eye pressure. A small device is placed in the eye to help drain excess fluid, reducing pressure that can damage the optic nerve and lead to vision loss. This procedure is often used for glaucoma treatment.

29 services26 patients

Laser repair to improve eye fluid flow 65855

Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.

26 services16 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.

20 services19 patients

Creation of shunt to improve eye fluid flow using tissue graft 66180

This procedure involves creating a new pathway for fluid to flow out of your eye using a tissue graft. It helps to lower eye pressure and prevent damage to your optic nerve, improving eye health and vision.

13 services11 patients

Hospital Affiliations CMS Care Compare

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

University Health System, Inc

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440015

Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37920 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

47.96/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

90.87

Promoting Interoperability

Improvement Activities

Cost

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Other Providers at the Same Location NPPES 12

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

LAUREN LINDSEY HARRIS M.D.

Ophthalmology