JAMES L JOHNSON II M.D.
NPI 1215926985
Surgery in Cody, WY
NPI Status: Active since October 17, 2005
Contact Information
125 W YELLOWSTONE AVE
CODY, WY
ZIP 82414
Phone: (307) 527-7129
Fax: (307) 587-7394
- Individual
- Male
- Years of Experience 34
- Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JAMES JOHNSON
This page provides the complete NPI Profile along with additional information for James Johnson, a provider established in Cody, Wyoming with a medical specialization in Surgery and more than 34 years of experience. He graduated from Creighton University School Of Medicine in 1992. The healthcare provider is registered in the NPI registry with number 1215926985 assigned on October 2005. The practitioner's primary taxonomy code is 208600000X with license number 6172A (WY). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1215926985
- Provider Name
- JAMES L JOHNSON II M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 125 W YELLOWSTONE AVE CODY, WY 82414
- Location Phone
- (307) 527-7129
- Location Fax
- (307) 587-7394
- Mailing Address
- 2820 CENTRAL AVE STE A BILLINGS, MT 59102
- Mailing Phone
- (406) 896-2478
- Mailing Fax
- (307) 587-7394
- Medical School Name
- CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1992
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-17-2005
- Last Update Date
- 10-21-2020
- Code Navigator
A surgeon like James Johnson treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Secondary Locations
- 822 Stoneridge Dr Ste 2
Bozeman, MT 59718
(406) 922-8346 - 2820 Central Ave Ste A
Billings, MT 59102
(406) 252-8346
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 6172A
- License State
- WY
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value HSA (No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0157896 | MEDICAID (05) | MT | |
| 020049170 | OTHER (01) | WY | RAILROAD MEDICARE |
| 95016 | OTHER (01) | MT | BLUE CROSS BLUE SHIELD MT |
| 113459100 | MEDICAID (05) | WY | |
| 308210 | OTHER (01) | WY | BLUE CROSS BLUE SHIELD |
Medicare Participation & PECOS Enrollment Status
James Johnson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
James Johnson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7416904370
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050404000849, I20060314000411
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Chemical destruction of first incompetent vein of arm or leg using imaging guidance
Chemical destruction of subsequent incompetent veins of arm or leg using imaging guidance
Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance
Destruction of subsequent incompetent veins of arm or leg using radiofrequency and imaging guidance
Established patient office or other outpatient visit, 30-39 minutes
Injection of chemical agent into multiple incompetent veins of leg
Ultrasonic guidance for needle placement
Varicose vein removal
This procedure involves using a chemical to close off a malfunctioning vein in your arm or leg. Imaging guidance is used to accurately locate the vein. This helps improve blood flow by rerouting it through healthier veins.
This service was performed 146 times for 92 patientsThis procedure involves using a chemical to close off unhealthy veins in your arm or leg. Imaging guidance helps ensure the chemical is accurately delivered to the problematic veins. This can improve blood flow and alleviate discomfort.
This service was performed 56 times for 43 patientsThis procedure involves using radiofrequency energy, a type of heat energy, to close off an unhealthy vein in your arm or leg. Imaging guidance helps ensure precise targeting of the vein. This helps improve blood flow by rerouting it through healthier veins.
This service was performed 100 times for 63 patientsThis procedure involves using radiofrequency, a type of energy wave, to close off veins in your arm or leg that aren't working properly. Imaging guidance helps ensure accuracy. The goal is to redirect blood flow to healthier veins, improving circulation.
This service was performed 27 times for 24 patientsThis 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.
This service was performed 25 times for 25 patientsThis procedure involves injecting a special chemical into problematic veins in the leg. The chemical helps to close off these veins, rerouting blood through healthier veins. This can alleviate discomfort and improve the appearance of the treated area.
This service was performed 24 times for 21 patientsUltrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
This service was performed 23 times for 20 patientsVaricose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.
This service was performed for 346 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.78 for a new patient copayment and $17.58 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 82414 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $87.12
- Minimum New Patient Price $56.42
- Maximum New Patient Price $170.72
- Average New Patient Copayment $21.78
- Minimum New Patient Copayment $14.1
- Maximum New Patient Copayment $42.68
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.32
- Minimum Established Patient Price $18.19
- Maximum Established Patient Price $139.32
- Average Established Patient Copayment $17.58
- Minimum Established Patient Copayment $4.54
- Maximum Established Patient Copayment $34.83
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Documentation of Current Medications in the Medical Record | 91% | 159 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Pain Assessment and Follow-Up | 24% | 159 |
| Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present | ||
| Patient-Specific Education | 5% | 37 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 84% | 73 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 53% | 138 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Provide Patient Access | 100% | 37 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Secure Messaging | 14% | 37 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215926985, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215926985, enumerated as an "individual" on October 17, 2005.
The provider is located at 125 W YELLOWSTONE AVE CODY, WY 82414 and the phone number is (307) 527-7129.
Surgery with taxonomy code 208600000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.
