JAMES L WALLER V PA-C
NPI 1093375966
Physician Assistant in Burlington, WI

Q: What is James Waller's NPI number?

The NPI number for James Waller is 1093375966. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Q: What is James Waller's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for James Waller was last updated on June 10, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 13, 2019PECOS EnrolledAccepts Medicare Assignment

709 SPRING VALLEY RD, BURLINGTON, WI 53105(262) 767-6020 Get Directions Write a Review

NPPES record last updated: June 10, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 10, 2022, Apr 26, 2022, Jul 3, 2019 and 1 more (4 updates tracked since 2019).

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About James L Waller V Pa-c NPPES

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

JAMES L WALLER V PA-C (NPI 1093375966) is an individual physician assistant in Burlington, Wisconsin, licensed in Wisconsin (4760) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, is affiliated with Aurora Memorial Hospital Burlington, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1093375966

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJAMES L WALLER VCredential: PA-C

Location Address709 SPRING VALLEY RDBurlington, WI 53105-7614

Mailing Address3301 W Forest Home AveMilwaukee, WI 53215-2843 · (262) 767-6020 · Fax (262) 767-6023

Phone(262) 767-6020

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 13, 2019

Last NPPES UpdateJune 10, 20224 updates tracked since enumeration

NPPES CertifiedJune 10, 2022

✔ NPI 1093375966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 4760

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

709 SPRING VALLEY RD, Burlington, WI 53105

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Secondary Practice Location 1

Location 1700 S Park StMadison, WI 53715-1830 · Phone (800) 680-4369

Other Identifiers 1

Medicaid100091606WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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 L Waller V Pa-c 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 ID1759617715

PECOS Enrollment IDI20190729002521

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.

Hospital Affiliations CMS Care Compare 2

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

Aurora Memorial Hospital Burlington

Acute Care Hospitals · Burlington, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520059

Location252 Mchenry StBurlington, WI 53105 · Racine County

Emergency services

Aurora Lakeland Medical Center

Acute Care Hospitals · Elkhorn, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520102

LocationW3985 County Road NnElkhorn, WI 53121 · Walworth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53105 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

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Other Providers at the Same Location NPPES 20

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

MS. ANN M THOMPSON APNP

Nurse Practitioner