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DR. JAMES GRATTON M.D.
NPI 1306279864
Emergency Medicine in Ponce, PR

Active since August 19, 2013PECOS EnrolledAccepts Medicare Assignment
82.04/100
CMS Quality Rating
917 AVE TITO CASTRO, PONCE, PR 00716(787) 844-2080 Get Directions Write a Review

NPPES record last updated: August 19, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. James Gratton M.d. NPPES

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

DR. JAMES GRATTON M.D. (NPI 1306279864) is an individual emergency medicine provider in Ponce, Puerto Rico, licensed in Puerto Rico (29593-R) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1306279864
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JAMES GRATTONCredential: M.D.
Location Address917 AVE TITO CASTROPonce, PR 00716-4717
Mailing Address2197 Blvd Luis A Ferre, Apt # 401Ponce, PR 00717-0636 · (956) 369-7717
Phone(787) 844-2080
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateAugust 19, 2013
✔ NPI 1306279864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in PR · 29593-R
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
917 AVE TITO CASTRO, Ponce, PR 00716
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Insurance Company 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 Gratton 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 ID1557655362
PECOS Enrollment IDI20171031000437
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 3

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
173 services168 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
45 services44 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
39 services37 patients

Hospital Affiliations CMS Care Compare 2

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450662
Location100 A Alton GloorBrownsville, TX 78526 · Cameron County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 00716 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
$88.07 typical visit price
range $56.86 – $172.44
Typical copayment $22.01 (range $14.21 – $43.11)
Most-billed visit code 99203
Established Patient
$100.24 typical visit price
range $18.24 – $140.44
Typical copayment $25.06 (range $4.56 – $35.11)
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.

82.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.1
Improvement Activities40

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.

DR. WILMER ELIEZER MORALES-HERNANDEZ MD
Emergency Medicine
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 840-4545
JUAN PABLO TORRES M.D.
Internal Medicine
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 840-4545
ANGELICA C MARRERO
Student in an Organized Health Care Education/Training Program
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 844-2080
JOHN VELEZ
Student in an Organized Health Care Education/Training Program
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 844-2080
DR. GEORGE PAUL FAHED MD
Internal Medicine (Pulmonary Disease)
917 AVE TITO CASTRO, TORRE MEDICA SAN LUCAS SUITE 701
PONCE, PR 00716
Ponce Municipio (787) 290-5577
DR. MANUEL ALBERTO PELLICIER MERCUCCI M.D.
General Practice
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 844-2080
ANA GABRIELA ALVAREZ PAGAN MD
Pediatrics
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 844-2080
EDUARDO JOSE COLON MELENDEZ
Internal Medicine
917 AVE TITO CASTRO
PONCE, PR 00716
Ponce Municipio (787) 844-9101

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 Gratton's NPI number?

The NPI number for James Gratton is 1306279864. It was assigned to this individual provider in the NPPES registry on August 19, 2013.

Where is James Gratton located?

James Gratton practices at 917 Ave Tito Castro, Ponce, PR 00716. The listed phone number is (787) 844-2080.

What is James Gratton's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is James Gratton enrolled in Medicare?

Yes. James Gratton 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 Gratton accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Insurance Company and UnitedHealthcare list James Gratton 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 Gratton affiliated with any hospitals?

According to CMS data, James Gratton is affiliated with South Texas Health System and Valley Regional Medical Center.

When was this NPI record last updated?

The NPPES record for James Gratton was last updated on August 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.