DR. JAMES LARIMER GARDNER III MD
NPI 1194766162
Family Medicine in New Wilmington, PA

Q: What is James Gardner's NPI number?

The NPI number for James Gardner is 1194766162. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Q: What is James Gardner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for James Gardner was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 09, 2006PECOS EnrolledAccepts Medicare Assignment

1995 MERCER NEW WILMINGTON RD, NEW WILMINGTON, PA 16142(724) 946-3564(724) 946-2156 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 3, 2025, May 18, 2025, Apr 27, 2021 (3 updates tracked since 2021).

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About Dr. James Larimer Gardner Iii Md NPPES

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

DR. JAMES LARIMER GARDNER III MD (NPI 1194766162) is an individual family medicine provider in New Wilmington, Pennsylvania, licensed in Pennsylvania (MD426144) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Upmc Jameson, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2002).

NPPES Registry Identity

NPI1194766162

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JAMES LARIMER GARDNER IIICredential: MD

Location Address1995 MERCER NEW WILMINGTON RDNew Wilmington, PA 16142-2021

Mailing Address1995 Mercer New Wilmington RdNew Wilmington, PA 16142-2021 · (724) 946-3564 · Fax (724) 946-2156

Phone(724) 946-3564

Fax(724) 946-2156

Sole ProprietorYes

Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2002

Enumeration DateJune 9, 2006

Last NPPES UpdateJune 3, 20253 updates tracked since enumeration

NPPES CertifiedJune 3, 2025

✔ NPI 1194766162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in PA · MD426144

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1995 MERCER NEW WILMINGTON RD, New Wilmington, PA 16142

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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 Larimer Gardner Iii 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 ID3274517875

PECOS Enrollment IDI20050909000405

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 9

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.

237 services74 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.

81 services45 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

81 services20 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

42 services42 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

31 services15 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

25 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Upmc Jameson

Acute Care Hospitals · New Castle, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390016

Location1211 Wilmington AvenueNew Castle, PA 16105 · Lawrence County

Emergency services

Butler Memorial Hospital

Acute Care Hospitals · Butler, PA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390168

LocationOne Hospital WayButler, PA 16001 · Butler County

Emergency services Birthing friendly

Upmc Horizon

Acute Care Hospitals · Greenville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390178

Location110 North Main StreetGreenville, PA 16125 · Mercer County

Emergency services Birthing friendly

Grove City Medical Center

Acute Care Hospitals · Grove City, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390266

Location631 North Broad Street Ext.Grove City, PA 16127 · Mercer County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16142 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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 14

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

8 suppliers41 claims79 services$6.09 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers21 claims25 services$0.99 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers11 claims11 services$36.81 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

4 suppliers26 claims26 services$94.39 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers26 claims76 services$39.20 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

2 suppliers11 claims61 services$23.98 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 6

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

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