DR. JAMES W FALCONER
NPI 1295704641
Internal Medicine in Thomasville, GA

Active since March 17, 2006PECOS EnrolledAccepts Medicare Assignment
119 W HILL ST, THOMASVILLE, GA 31792(229) 225-1900(229) 225-3493 Get Directions Write a Review

NPPES record last updated: April 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. James W Falconer NPPES

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

DR. JAMES W FALCONER (NPI 1295704641) is an individual internal medicine provider in Thomasville, Georgia, licensed in Georgia (044213) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Archbold Memorial, and is a graduate of Emory University School Of Medicine (1999).

NPPES Registry Identity

NPI1295704641
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JAMES W FALCONER
Location Address119 W HILL STThomasville, GA 31792-6618
Mailing Address119 W Hill StThomasville, GA 31792-6618 · (229) 225-1900 · Fax (229) 225-3493
Fax(229) 225-3493
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 1999
Enumeration DateMarch 17, 2006
Last NPPES UpdateApril 30, 2012
NPI 1295704641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in GA · 044213
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.
119 W HILL ST, Thomasville, GA 31792

Other Identifiers 2

Medicare PIN11BDRQKGA
Medicare UPINH12407GA

Accepted 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 W Falconer 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 ID7810073897
PECOS Enrollment IDI20080401000313
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 47

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.

Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
1,740 services17 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
997 services387 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.
930 services359 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
539 services355 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.
538 services371 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
527 services334 patients

Hospital Affiliations CMS Care Compare 3

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

Archbold Memorial

Acute Care Hospitals · Thomasville, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110038
Location915 Gordon Avenue & Mimosa DriveThomasville, GA 31792 · Thomas County
Emergency services Birthing friendly

Colquitt Regional Medical Center

Acute Care Hospitals · Moultrie, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110105
Location3131 South Main StreetMoultrie, GA 31768 · Colquitt County
Emergency services Birthing friendly

Archbold Grady

Acute Care Hospitals · Cairo, GA
OwnershipVoluntary non-profit - Private
CMS Certification Number110121
Location1155 5th Street, SECairo, GA 39828 · Grady County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31792 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

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.
99%8,303 patients5/55-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…
65%715 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%179 patients4/55-star benchmark: 100%
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.
46%1,684 patients2/55-star benchmark: 97%
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…
96%1,639 patients4/55-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…
74%1,639 patients4/55-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.
42%1,639 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.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers55 claims105 services$5.49 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers18 claims21 services$0.93 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
6 suppliers13 claims13 services$19.21 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers14 claims80 services$2.69 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers22 claims22 services$101.14 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers22 claims22 services$34.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

Dermatology
119 W HILL ST
THOMASVILLE, GA 31792
Internal Medicine (Pulmonary Disease)
119 W HILL ST
THOMASVILLE, GA 31792
Internal Medicine
119 W HILL ST
THOMASVILLE, GA 31792
Nurse Practitioner (Family)
119 W HILL ST
THOMASVILLE, GA 31792
Dermatology
119 W HILL ST
THOMASVILLE, GA 31792
Internal Medicine
119 W HILL ST
THOMASVILLE, GA 31792
Physician Assistant
119 W HILL ST
THOMASVILLE, GA 31792
Pathology (Dermatopathology)
119 W HILL ST
THOMASVILLE, GA 31792

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 Falconer's NPI number?

The NPI number for James Falconer is 1295704641. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is James Falconer located?

James Falconer practices at 119 W Hill St, Thomasville, GA 31792. The listed phone number is (229) 225-1900.

What is James Falconer's specialty?

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

Is James Falconer enrolled in Medicare?

Yes. James Falconer 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 Falconer accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list James Falconer 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 Falconer affiliated with any hospitals?

According to CMS data, James Falconer is affiliated with Archbold Memorial, Colquitt Regional Medical Center and Archbold Grady.

When was this NPI record last updated?

The NPPES record for James Falconer was last updated on April 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.