JAMES W STONE MD
NPI 1295839298
Orthopaedic Surgery in Milwaukee, WI

Q: What is James Stone's NPI number?

The NPI number for James Stone is 1295839298. It was assigned to this individual provider in the NPPES registry on September 11, 2006.

Q: What is James Stone's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for James Stone was last updated on February 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 September 11, 2006PECOS Enrolled

81.61/100

CMS Quality Rating

3237 S 16TH ST, SUITE 210, MILWAUKEE, WI 53215(414) 384-6700(414) 384-3008 Get Directions Write a Review

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

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About James W Stone Md NPPES

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

JAMES W STONE MD (NPI 1295839298) is an individual orthopaedic surgery provider in Milwaukee, Wisconsin, licensed in Wisconsin (30262) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295839298

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameJAMES W STONECredential: MD

Location Address3237 S 16TH ST, SUITE 210Milwaukee, WI 53215-4526

Mailing Address3077 N Mayfair Rd Ste 305Wauwatosa, WI 53222-4305 · (414) 384-6700 · Fax (414) 727-1058

Phone(414) 384-6700

Fax(414) 384-3008

Sole ProprietorNo

Enumeration DateSeptember 11, 2006

Last NPPES UpdateFebruary 25, 2020

✔ NPI 1295839298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in WI · 30262

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License 30262 (WI)

3237 S 16TH ST, Milwaukee, WI 53215

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Other Identifiers 1

Medicaid31559200WI

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James W Stone Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

Medicare enrollment records show James Stone reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Midwest Orthopedic Specialty Hospital, LLC

2.2 mi

Rehabilitation

4861 S 27TH ST
Greenfield, WI 53221

Reassigned Medicare billing, Wisconsin enrollment
90 clinicians in this Medicare group

NPI 1407508567 (414) 567-3022

Orthopedic Surgeons Of Wisconsin, S.C.

8.4 mi

Orthopaedic Surgery

3077 N MAYFAIR RD STE 305
Wauwatosa, WI 53222

Reassigned Medicare billing, Wisconsin enrollment
Medicare enrollment name: Orthopedic Surgeons Of Wisconsin Sc
57 clinicians in this Medicare group

NPI 1295769321 (414) 384-6700

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 9

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, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

143 services29 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

85 services49 patients

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose J7321

Hyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.

82 services23 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.

64 services51 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

36 services35 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

35 services32 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53215 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

81.61/100

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

Scored as part of a group practice

Quality

78.37

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

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

Continuous passive motion exercise device for use on knee only E0935

DME-Other DME · category DE000N

1 supplier25 claims473 services$18.82 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 20

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

MICHAEL SEAN STIEWE PHARMD

Pharmacist