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DR. JAMES P TWESTEN-OTOOLE MD
NPI 1174599344
Family Medicine - Addiction Medicine in Norton Shores, MI

Active since February 27, 2006PECOS EnrolledAccepts Medicare Assignment
3570 HENRY ST, SUITE 220, NORTON SHORES, MI 49441(616) 685-6920(231) 672-7717 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 11, 2023, Dec 15, 2021, Mar 5, 2018 (3 updates tracked since 2018).

About Dr. James P Twesten-otoole Md NPPES

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

DR. JAMES P TWESTEN-OTOOLE MD (NPI 1174599344) is an individual addiction medicine provider in Norton Shores, Michigan, licensed in Michigan (4301072802) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Trinity Health Muskegon Hospital, and is a graduate of University Of Michigan Medical School (1998).

NPPES Registry Identity

NPI1174599344
Entity TypeIndividualMale
Primary Taxonomy207QA0401X
Provider Legal NameDR. JAMES P TWESTEN-OTOOLECredential: MD
Location Address3570 HENRY ST, SUITE 220Norton Shores, MI 49441
Mailing AddressPo Box 776982Chicago, IL 60677-6982 · (800) 494-5797
Phone(616) 685-6920
Fax(231) 672-7717
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1998
Enumeration DateFebruary 27, 2006
Last NPPES UpdateJuly 11, 20233 updates tracked since enumeration
NPPES CertifiedJuly 11, 2023
✔ NPI 1174599344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in MI · 4301072802
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 4301072802 (MI)
3570 HENRY ST, Norton Shores, MI 49441
Open in Google Maps ↗

Other Identifiers 1

Medicaid1174599344MI

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

Dr. James P Twesten-otoole 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 ID5193623825
PECOS Enrollment IDI20031219000437
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

2

Medicare enrollment records show James Twesten-otoole reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mercy Physician Network
6.3 mi
Family Medicine
3443 FARR RD
Fruitport, MI 49415
  • Reassigned Medicare billing, Michigan enrollment
  • 130 clinicians in this Medicare group
NPI 1639502701 (231) 672-2900
Advantage Health/Saint Mary's Medical Group
28 mi
Clinic/Center
475 S STATE ST
Sparta, MI 49345
  • Reassigned Medicare billing, Michigan enrollment
  • 737 clinicians in this Medicare group
NPI 1760599906 (616) 685-1300

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

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 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.
41 services12 patients

Hospital Affiliations CMS Care Compare

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

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230066
Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49441 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers12 claims40 services$6.83 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers26 claims27 services$17.65 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers28 claims29 services$91.30 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
5 suppliers46 claims46 services$195.85 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 2

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

ALEXUS MONYAE HELMS
Behavior Technician
3570 HENRY ST
NORTON SHORES, MI 49441
Muskegon County (231) 672-6746
GABRIEL A DUNN M.D.
Family Medicine
3570 HENRY ST
NORTON SHORES, MI 49441
Muskegon County (231) 370-1286

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 Twesten-otoole's NPI number?

The NPI number for James Twesten-otoole is 1174599344. It was assigned to this individual provider in the NPPES registry on February 27, 2006.

Where is James Twesten-otoole located?

James Twesten-otoole practices at 3570 Henry St Suite 220, Norton Shores, MI 49441. The listed phone number is (616) 685-6920.

What is James Twesten-otoole's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Is James Twesten-otoole enrolled in Medicare?

Yes. James Twesten-otoole 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 Twesten-otoole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Twesten-otoole reassigns Medicare benefits to 2 organizations: Mercy Physician Network (Fruitport, MI) and Advantage Health/Saint Mary's Medical Group (Sparta, 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 Twesten-otoole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Twesten-otoole 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 1 other insurer list James Twesten-otoole 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.

Is James Twesten-otoole affiliated with any hospitals?

According to CMS data, James Twesten-otoole is affiliated with Trinity Health Muskegon Hospital.

When was this NPI record last updated?

The NPPES record for James Twesten-otoole was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.