JAMES BENJAMIN SINCEBAUGH
NPI 1235661711
Internal Medicine - Pulmonary Disease in Charleston, SC

Q: What is James Sincebaugh's NPI number?

The NPI number for James Sincebaugh is 1235661711. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Q: What is James Sincebaugh's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for James Sincebaugh was last updated on September 4, 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

73.84/100

CMS Quality Rating

96 JONATHAN LUCAS STREET, STE 816 MSC 630, CHARLESTON, SC 29425(843) 792-2300 Get Directions Write a Review

NPPES record last updated: September 4, 2023. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 4, 2023, Jun 23, 2023, Aug 15, 2018 and 1 more (4 updates tracked since 2018).

On this page

About James Benjamin Sincebaugh NPPES

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

JAMES BENJAMIN SINCEBAUGH (NPI 1235661711) is an individual pulmonary disease provider in Charleston, South Carolina, licensed in South Carolina (90741) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of University Of Pittsburgh School Of Medicine (2017).

NPPES Registry Identity

NPI1235661711

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameJAMES BENJAMIN SINCEBAUGH

Location Address96 JONATHAN LUCAS STREET, STE 816 MSC 630Charleston, SC 29425-8900

Mailing Address1270 Willivee DrDecatur, GA 30033-4120 · (585) 704-4868

Phone(843) 792-2300

Sole ProprietorNo

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2017

Enumeration DateApril 3, 2017

Last NPPES UpdateSeptember 4, 20234 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2023

✔ NPI 1235661711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in SC · 90741✔ Licensed in GA · 86605

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 64250 (MN)

96 JONATHAN LUCAS STREET, Charleston, SC 29425

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare 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 Benjamin Sincebaugh 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 ID8022381862

PECOS Enrollment IDI20231030000677

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 high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

101 services71 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.

90 services41 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

81 services30 patients

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.

69 services59 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.

60 services21 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

52 services36 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.

33 services28 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

30 services30 patients

Test to measure expiratory airflow and volume 94010

21 services21 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

21 services21 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

20 services11 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

19 services13 patients

Test to examine how well the lungs exchange gases 94729

18 services18 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

15 services15 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

15 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services14 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Tidelands Georgetown Memorial Hospital

Acute Care Hospitals · Georgetown, SC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420020

Location606 Black River Rd Drawer 1718Georgetown, SC 29440 · Georgetown County

Emergency services

Musc Health Columbia Medical Center Downtown

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420026

Location2435 Forest DriveColumbia, SC 29204 · Richland County

Emergency services

Hilton Head Regional Medical Center

Acute Care Hospitals · Hilton Head Island, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number420080

Location25 Hospital Center BlvdHilton Head Island, SC 29925 · Beaufort County

Emergency services Birthing friendly

Musc Health Florence Medical Center

Acute Care Hospitals · Florence, SC

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number420091

Location805 Pamplico Hwy Box 100550Florence, SC 29505 · Florence County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

73.84/100

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

Scored as part of a group practice

Quality

60.28

Promoting Interoperability

Improvement Activities

Cost

53.36

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.

DR. RYAN PATRICK LAWSON DO

Radiology (Diagnostic Radiology)

96 JONATHAN LUCAS STREET, SUITE 210, MSC 323
CHARLESTON, SC 29425

Charleston County (843) 792-2300

DR. KRISTINE I PARKER MBBS

Student in an Organized Health Care Education/Training Program

96 JONATHAN LUCAS STREET, SUITE 816
CHARLESTON, SC 29425

Charleston County (843) 792-2529

DR. ALEXANDRA NICOLE DOMINIANNI MD

Surgery (Plastic and Reconstructive Surgery)

96 JONATHAN LUCAS STREET, MSC 613
CHARLESTON, SC 29425

Charleston County (843) 792-2098

KANEEZ ZAINAB M.D.

Internal Medicine

96 JONATHAN LUCAS STREET, SUITE 807 CSB MSC 623
CHARLESTON, SC 29425

Charleston County (843) 792-4074

STEPHEN ROSS FULLER MD

Internal Medicine

96 JONATHAN LUCAS STREET, SUITE 807 CSB, MSC623
CHARLESTON, SC 29425

Charleston County (843) 792-2731

LISA BETZ M.D.

Radiology (Diagnostic Radiology)

96 JONATHAN LUCAS STREET, SUITE 210, MSC 323
CHARLESTON, SC 29425

Charleston County (843) 792-4033

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 Sincebaugh's NPI number?

The NPI number for James Sincebaugh is 1235661711. It was assigned to this individual provider in the NPPES registry on April 3, 2017.

Where is James Sincebaugh located?

James Sincebaugh practices at 96 Jonathan Lucas Street Ste 816 Msc 630, Charleston, SC 29425. The listed phone number is (843) 792-2300.

What is James Sincebaugh's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is James Sincebaugh enrolled in Medicare?

Yes. James Sincebaugh 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 Sincebaugh accept?

Health plans from BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare and UnitedHealthcare list James Sincebaugh 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 Sincebaugh affiliated with any hospitals?

According to CMS data, James Sincebaugh is affiliated with Musc Medical Center, Tidelands Georgetown Memorial Hospital, Musc Health Columbia Medical Center Downtown, Hilton Head Regional Medical Center and Musc Health Florence Medical Center.

When was this NPI record last updated?

The NPPES record for James Sincebaugh was last updated on September 4, 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.