JAMES LUKE ELLENBURG M.D.
NPI 1205290087
Urology in Opelika, AL

Active since April 07, 2016PECOS EnrolledAccepts Medicare Assignment
83.73/100
CMS Quality Rating
121 N 20TH ST STE 19, OPELIKA, AL 36801(334) 749-8146 Get Directions Write a Review

NPPES record last updated: November 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About James Luke Ellenburg M.d. NPPES

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

JAMES LUKE ELLENBURG M.D. (NPI 1205290087) is an individual urology provider in Opelika, Alabama, licensed in Alabama (MD.36604) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2016).

NPPES Registry Identity

NPI1205290087
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameJAMES LUKE ELLENBURGCredential: M.D.
Location Address121 N 20TH ST STE 19Opelika, AL 36801-5456
Mailing Address121 N 20th St Ste 19Opelika, AL 36801-5456 · (334) 749-8146
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2016
Enumeration DateApril 7, 2016
Last NPPES UpdateNovember 1, 2022
NPPES CertifiedNovember 1, 2022
NPI 1205290087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License Licensed in AL · MD.36604
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
121 N 20TH ST STE 19, Opelika, AL 36801

Accepted 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 Luke Ellenburg 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 ID1557657137
PECOS Enrollment IDI20210714000653
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 17

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.
314 services199 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.
249 services193 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.
134 services134 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
73 services32 patients
Diagnostic exam of bladder and urethra using an endoscope 52000
This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.
72 services70 patients
Imaging of urinary tract following injection of a contrast agent 74420
This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.
58 services51 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36801 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

83.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.84
Promoting Interoperability100
Improvement Activities40
Cost70.93

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.

Physician Assistant (Medical)
121 N 20TH ST STE 19
OPELIKA, AL 36801
Urology
121 N 20TH ST STE 19
OPELIKA, AL 36801
Urology
121 N 20TH ST STE 19
OPELIKA, AL 36801
Urology
121 N 20TH ST STE 19
OPELIKA, AL 36801
Urology
121 N 20TH ST STE 19
OPELIKA, AL 36801
Urology
121 N 20TH ST STE 19
OPELIKA, AL 36801

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 Ellenburg's NPI number?

The NPI number for James Ellenburg is 1205290087. It was assigned to this individual provider in the NPPES registry on April 7, 2016.

Where is James Ellenburg located?

James Ellenburg practices at 121 N 20th St Ste 19, Opelika, AL 36801. The listed phone number is (334) 749-8146.

What is James Ellenburg's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is James Ellenburg enrolled in Medicare?

Yes. James Ellenburg 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 Ellenburg accept?

Health plans from Blue Cross and Blue Shield of Alabama and UnitedHealthcare list James Ellenburg 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 Ellenburg was last updated on November 1, 2022. 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.