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JAMES B DOWNEY MD
NPI 1184648305
Surgery in Highlands Ranch, CO

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
9330 S UNIVERSITY BLVD STE 230, HIGHLANDS RANCH, CO 80126(720) 516-0600(720) 516-0601 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 15, 2022, Jan 28, 2019 (2 updates tracked since 2019).

About James B Downey Md NPPES

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

JAMES B DOWNEY MD (NPI 1184648305) is an individual surgery provider in Highlands Ranch, Colorado, licensed in Colorado (36210) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Colorado School Of Medicine, Denver (1992).

NPPES Registry Identity

NPI1184648305
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJAMES B DOWNEYCredential: MD
Location Address9330 S UNIVERSITY BLVD STE 230Highlands Ranch, CO 80126-5049
Mailing Address2695 Rocky Mountain Ave Ste 150Loveland, CO 80538-9071 · (970) 624-2409 · Fax (970) 490-4155
Phone(720) 516-0600
Fax(720) 516-0601
Sole ProprietorNo
Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 1992
Enumeration DateJuly 27, 2006
Last NPPES UpdateJanuary 16, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2025
✔ NPI 1184648305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in CO · 36210
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
9330 S UNIVERSITY BLVD STE 230, Highlands Ranch, CO 80126
Open in Google Maps ↗

Secondary Practice Locations 2

Location 112605 E 16th AveAurora, CO 80045-2545 · Phone (720) 848-0000
Location 22121 E Harmony Rd Unit 330Fort Collins, CO 80528-3403 · Phone (970) 221-5878 · Fax (970) 221-3564

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.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 B Downey 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 ID6103887146
PECOS Enrollment IDI20041025000379
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 4

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
33 services33 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services18 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
18 services14 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
18 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80126 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

POUDRE VALLEY MEDICAL GROUP, LLC
Surgery
9330 S UNIVERSITY BLVD STE 230
HIGHLANDS RANCH, CO 80126
Douglas County (720) 516-0600
DR. CASH CLAYTON STERLING MD
Surgery
9330 S UNIVERSITY BLVD STE 230
HIGHLANDS RANCH, CO 80126
Douglas County (720) 516-0600
DR. CAITLYN DRAGON LESH M.D.
Surgery
9330 S UNIVERSITY BLVD STE 230
HIGHLANDS RANCH, CO 80126
Douglas County (720) 516-9092

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 Downey's NPI number?

The NPI number for James Downey is 1184648305. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is James Downey located?

James Downey practices at 9330 S University Blvd Ste 230, Highlands Ranch, CO 80126. The listed phone number is (720) 516-0600.

What is James Downey's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is James Downey enrolled in Medicare?

Yes. James Downey 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 Downey accept?

Health plans from Medica and UnitedHealthcare list James Downey 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 Downey was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.