DR. JAMES R PACHOLKA MD
NPI 1255395646
Surgery in Portsmouth, OH

Q: What is James Pacholka's NPI number?

The NPI number for James Pacholka is 1255395646. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Q: What is James Pacholka's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for James Pacholka was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 13, 2006PECOS EnrolledAccepts Medicare Assignment

76.08/100

CMS Quality Rating

1711 27TH ST STE 402, PORTSMOUTH, OH 45662(740) 356-3562(740) 355-6938 Get Directions Write a Review

NPPES record last updated: December 17, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 17, 2020, Jul 27, 2020, May 11, 2016 (3 updates tracked since 2016).

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About Dr. James R Pacholka Md NPPES

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

DR. JAMES R PACHOLKA MD (NPI 1255395646) is an individual surgery provider in Portsmouth, Ohio, licensed in Ohio (35.127947) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Southern Ohio Medical Center, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1255395646

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. JAMES R PACHOLKACredential: MD

Location Address1711 27TH ST STE 402Portsmouth, OH 45662-2669

Mailing Address1735 27th St Ste B06Portsmouth, OH 45662-2681 · (740) 356-6942 · Fax (740) 356-7851

Phone(740) 356-3562

Fax(740) 355-6938

Sole ProprietorYes

Medical School CMSOtherGraduated 1986

Enumeration DateApril 13, 2006

Last NPPES UpdateDecember 17, 20203 updates tracked since enumeration

NPPES CertifiedDecember 17, 2020

✔ NPI 1255395646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in OH · 35.127947✔ Licensed in NY · 174644

Definition

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.

1711 27TH ST STE 402, Portsmouth, OH 45662

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Other Identifiers 3

Medicaid01344687NY

Medicaid0175848OH

Medicaid7100414720KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Dr. James R Pacholka 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 ID5294890190

PECOS Enrollment IDI20160518002271

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.

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.

76 services33 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.

47 services46 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.

42 services38 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.

41 services25 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.

35 services26 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.

28 services28 patients

Hospital Affiliations CMS Care Compare

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

Southern Ohio Medical Center

Acute Care Hospitals · Portsmouth, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360008

Location1805 27th StreetPortsmouth, OH 45662 · Scioto County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45662 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

76.08/100

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

Scored as part of a group practice

Quality

64.17

Promoting Interoperability

100

Improvement Activities

Cost

43.98

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. ANDREW JAMES DITTENHOFER D.O

Surgery