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JAMES GRANT HOWARD M.D.
NPI 1255711453
Family Medicine in Lexington, KY

Active since June 02, 2015PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
2040 HARRODSBURG RD STE 200, LEXINGTON, KY 40503(859) 899-7994(859) 899-7993 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 7, 2020, Jun 14, 2018 (2 updates tracked since 2018).

About James Grant Howard M.d. NPPES

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

JAMES GRANT HOWARD M.D. (NPI 1255711453) is an individual family medicine provider in Lexington, Kentucky, licensed in Kentucky (51052) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Lexington, and maintains a secondary practice location in Daytona Beach.

NPPES Registry Identity

NPI1255711453
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES GRANT HOWARDCredential: M.D.
Location Address2040 HARRODSBURG RD STE 200Lexington, KY 40503
Mailing Address2700 Stanley Gault Pkwy Ste 129Louisville, KY 40223-5176 · (502) 253-4900 · Fax (502) 489-5750
Phone(859) 899-7994
Fax(859) 899-7993
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 2014
Enumeration DateJune 2, 2015
Last NPPES UpdateDecember 7, 20202 updates tracked since enumeration
NPPES CertifiedDecember 7, 2020
✔ NPI 1255711453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 51052
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.
2040 HARRODSBURG RD STE 200, Lexington, KY 40503
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Secondary Practice Location 1

Location 1201 N Clyde Morris Blvd, Suite 200Daytona Beach, FL 32114-2724 · Phone (386) 254-4165 · Fax (386) 254-4339

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Grant Howard M.d. 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 ID1850603499
PECOS Enrollment IDI20180627001130
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.

Medicare Billing Reassignment

Medicare enrollment records show James Howard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baptist Health Medical Group Inc
5.0 mi
Nurse Practitioner
100 PROVIDENCE WAY STE 200
Nicholasville, KY 40356
  • Reassigned Medicare billing, Kentucky enrollment
  • 1,441 clinicians in this Medicare group
NPI 1255805586 (859) 260-5370

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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 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.
145 services128 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
54 services54 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
34 services31 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
25 services24 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
24 services24 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.
21 services19 patients

Hospital Affiliations CMS Care Compare

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

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

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.
92%499 patients3/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
13%144 patients1/55-star benchmark: 88%
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 3

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

SARAH BETH BROWN APRN
Nurse Practitioner (Family)
2040 HARRODSBURG RD STE 200
LEXINGTON, KY 40503
Fayette County (859) 899-7994
MRS. STEFANIE BROCK BAKER PA-C
Physician Assistant
2040 HARRODSBURG RD STE 200
LEXINGTON, KY 40503
Fayette County (859) 899-7993
SUSIE K PRUITT APRN
Nurse Practitioner (Family)
2040 HARRODSBURG RD STE 200
LEXINGTON, KY 40503
Fayette County (859) 899-7993

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 Howard's NPI number?

The NPI number for James Howard is 1255711453. It was assigned to this individual provider in the NPPES registry on June 2, 2015.

Where is James Howard located?

James Howard practices at 2040 Harrodsburg Rd Ste 200, Lexington, KY 40503. The listed phone number is (859) 899-7994.

What is James Howard's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Howard enrolled in Medicare?

Yes. James Howard 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.

Which organization bills Medicare for James Howard's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Howard reassigns Medicare benefits to Baptist Health Medical Group Inc (Nicholasville, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Howard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Howard accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and CareSource list James Howard 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 Howard affiliated with any hospitals?

According to CMS data, James Howard is affiliated with Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for James Howard was last updated on December 7, 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.