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JAMES R BURNS MD
NPI 1225022080
Internal Medicine in Neenah, WI

Active since September 08, 2005PECOS EnrolledAccepts Medicare Assignment
77.77/100
CMS Quality Rating

NPPES record last updated: November 6, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About James R Burns Md NPPES

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

JAMES R BURNS MD (NPI 1225022080) is an individual internal medicine provider in Neenah, Wisconsin, licensed in Wisconsin (21213) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension Ne Wisconsin - St Elizabeth Campus, and is a graduate of Other (1974).

NPPES Registry Identity

NPI1225022080
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJAMES R BURNSCredential: MD
Location Address101 MAIN STNeenah, WI 54956-2570
Mailing Address101 Main StNeenah, WI 54956-2570 · (920) 727-4220
Phone(920) 727-4220
Sole ProprietorNo
Medical School CMSOtherGraduated 1974
Enumeration DateSeptember 8, 2005
Last NPPES UpdateNovember 6, 2012
✔ NPI 1225022080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 21213
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
101 MAIN ST, Neenah, WI 54956
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Other Identifiers 3

Medicaid30131000WI
Medicare UPINB51867
Medicare PIN002071018WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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 R Burns 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 ID7113058660
PECOS Enrollment IDI20100626000401
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 5

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
1,248 services737 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
767 services563 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
113 services107 patients
Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227
An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.
31 services31 patients
Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227
An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.
15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Ascension NE Wisconsin - St Elizabeth Campus

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520009
Location1506 S Oneida StAppleton, WI 54915 · Outagamie County
Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Ascension Calumet Hospital

Critical Access Hospitals · Chilton, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521317
Location614 Memorial DriveChilton, WI 53014 · Calumet County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54956 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

77.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.47
Promoting Interoperability77
Improvement Activities40
Cost63.8

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms
Lower rates are better for this measure.
89%37 patients1/55-star benchmark: 100%
Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%37 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
62%232 patients3/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
61%340 patients3/55-star benchmark: 100%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
52%402 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
72%449 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
51%97 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%1,234 patients5/55-star benchmark: 99%
Patient-Specific Education
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.
81%1,262 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
51%1,200 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
17%583 patients1/55-star benchmark: 88%
Provide Patient Access
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…
68%1,262 patients3/55-star benchmark: 100%
Secure Messaging
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…
22%1,262 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
26%1,262 patients
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 18

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

STEPHEN T CRUZ MD
Family Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
MARK D MOHR MD
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
KELSEY KIENERT M.D.
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 720-1463
TOMASZ K MIASKOWSKI MD
Family Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-5810
WILLIAM L NELSON MD
Internal Medicine
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4220
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Clinic/Center (Multi-Specialty)
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4200
NICOLE VER VOORT APNP
Nurse Practitioner
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 720-1463
RACHEL ANN COLLAR
Physician Assistant (Medical)
101 MAIN ST
NEENAH, WI 54956
Winnebago County (920) 727-4200

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 Burns's NPI number?

The NPI number for James Burns is 1225022080. It was assigned to this individual provider in the NPPES registry on September 8, 2005.

Where is James Burns located?

James Burns practices at 101 Main St, Neenah, WI 54956. The listed phone number is (920) 727-4220.

What is James Burns's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Burns enrolled in Medicare?

Yes. James Burns 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 Burns accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list James Burns 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.

Is James Burns affiliated with any hospitals?

According to CMS data, James Burns is affiliated with Ascension NE Wisconsin - St Elizabeth Campus, Thedacare Regional Medical Center - Appleton Inc and Ascension Calumet Hospital.

When was this NPI record last updated?

The NPPES record for James Burns was last updated on November 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.