JAMES NICHOLAS FAHEY MD
NPI 1205368602
Family Medicine in Edinburg, TX

Q: What is James Fahey's NPI number?

The NPI number for James Fahey is 1205368602. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Q: What is James Fahey'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 Fahey was last updated on July 27, 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.

Active since April 03, 2017PECOS EnrolledAccepts Medicare Assignment

81.44/100

CMS Quality Rating

3804 S JACKSON RD STE 2, EDINBURG, TX 78539(956) 296-3021(956) 296-3020 Get Directions Write a Review

NPPES record last updated: July 27, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 27, 2023, Jul 21, 2020 (2 updates tracked since 2020).

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About James Nicholas Fahey Md NPPES

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

JAMES NICHOLAS FAHEY MD (NPI 1205368602) is an individual family medicine provider in Edinburg, Texas, licensed in Texas (S4465) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2017).

NPPES Registry Identity

NPI1205368602

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJAMES NICHOLAS FAHEYCredential: MD

Location Address3804 S JACKSON RD STE 2Edinburg, TX 78539-6683

Mailing Address2102 Treasure Hills Blvd # 3.14406Harlingen, TX 78550-8736 · (956) 296-1437 · Fax (956) 296-6842

Phone(956) 296-3021

Fax(956) 296-3020

Sole ProprietorNo

Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2017

Enumeration DateApril 3, 2017

Last NPPES UpdateJuly 27, 20232 updates tracked since enumeration

NPPES CertifiedJuly 27, 2023

✔ NPI 1205368602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · S4465

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.

3804 S JACKSON RD STE 2, Edinburg, TX 78539

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Other Identifiers 1

OtherH08MV75001TX · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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 Nicholas Fahey 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 ID2062781503

PECOS Enrollment IDI20200611003346

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 6

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.

43 services30 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.

39 services19 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.

29 services25 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.

26 services15 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

19 services16 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

19 services17 patients

Hospital Affiliations CMS Care Compare 2

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450119

Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450128

Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

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.

81.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.83

Promoting Interoperability

Improvement Activities

Cost

49.23

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

0%27 patients

Breast Cancer Screening

36%212 patients2/55-star benchmark: 93%

Cervical Cancer Screening

35%393 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

50%120 patients3/55-star benchmark: 87%

Colorectal Cancer Screening

27%494 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

27%324 patients2/55-star benchmark: 91%

Diabetes: Eye Exam

15%252 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

77%252 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

50%1,771 patients2/55-star benchmark: 100%

e-Prescribing

98%617 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

37%169 patients2/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

36%935 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

33%728 patients2/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

14%1,224 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 45% · 826 patients

Patients screened: 45% · 826 patients

82%28 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

81%452 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

65%252 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 2% · 184 patients

Patients totalRate: 6% · 187 patients

6%187 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 8

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

SARAH BAGUIWET SOUFFRANT FNP

Nurse Practitioner (Family)