JAMES L. MASDON M.D.
NPI 1295848471
Otolaryngology in Guntersville, AL

Active since August 15, 2006PECOS EnrolledAccepts Medicare Assignment
84.33/100
CMS Quality Rating
55 ROWE DR STE B, GUNTERSVILLE, AL 35976(256) 571-8450(256) 840-4584 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About James L. Masdon M.d. NPPES

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

JAMES L. MASDON M.D. (NPI 1295848471) is an individual otolaryngology provider in Guntersville, Alabama, licensed in Alabama (00023577) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (1999).

NPPES Registry Identity

NPI1295848471
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameJAMES L. MASDONCredential: M.D.
Location Address55 ROWE DR STE BGuntersville, AL 35976-7366
Mailing Address602 Corley AveBoaz, AL 35957-5952 · (256) 571-8450 · Fax (256) 840-4584
Fax(256) 840-4584
Sole ProprietorYes
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1999
Enumeration DateAugust 15, 2006
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
NPI 1295848471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in AL · 00023577
Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

55 ROWE DR STE B, Guntersville, AL 35976

Other Names 1

Professional Name (2)James L Masdon M.d.

Other Identifiers 1

Other515-35385AL · Bcbs Of Alabama

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

James L. Masdon 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 ID9133013329
PECOS Enrollment IDI20040210000109
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.

Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
770 services19 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.
155 services139 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
106 services99 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.
84 services84 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
83 services70 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.
81 services81 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35976 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

84.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.96
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.
100%1,098 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…
3%40 patients1/55-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.
96%2,924 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.
80%2,448 patients4/55-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…
89%2,448 patients4/55-star benchmark: 100%
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.
1%2,448 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.

Other Providers at the Same Location NPPES 5

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

Nurse Practitioner (Family)
55 ROWE DR STE B
GUNTERSVILLE, AL 35976
Audiologist
55 ROWE DR STE B
GUNTERSVILLE, AL 35976
Audiologist
55 ROWE DR STE B
GUNTERSVILLE, AL 35976
Physician Assistant (Medical)
55 ROWE DR STE B
GUNTERSVILLE, AL 35976
Otolaryngology
55 ROWE DR STE B
GUNTERSVILLE, AL 35976

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 Masdon's NPI number?

The NPI number for James Masdon is 1295848471. It was assigned to this individual provider in the NPPES registry on August 15, 2006. The provider is also known as James L Masdon M.D..

Where is James Masdon located?

James Masdon practices at 55 Rowe Dr Ste B, Guntersville, AL 35976. The listed phone number is (256) 571-8450.

What is James Masdon's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James Masdon enrolled in Medicare?

Yes. James Masdon 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 Masdon accept?

Health plans from Blue Cross and Blue Shield of Alabama and Oscar Insurance Company list James Masdon 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.

When was this NPI record last updated?

The NPPES record for James Masdon was last updated on December 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.