JAMES NIKOLEIT MD
NPI 1306813316
Internal Medicine in Lake In The Hills, IL

Q: What is James Nikoleit's NPI number?

The NPI number for James Nikoleit is 1306813316. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Q: What is James Nikoleit's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for James Nikoleit was last updated on August 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 08, 2006PECOS EnrolledAccepts Medicare Assignment

69.02/100

CMS Quality Rating

170 NORTH LAKEWOOD ROAD, LAKE IN THE HILLS, IL 60156(224) 569-4000(224) 569-4001 Get Directions Write a Review

NPPES record last updated: August 31, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 31, 2022, Mar 23, 2018 (2 updates tracked since 2018).

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About James Nikoleit Md NPPES

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

JAMES NIKOLEIT MD (NPI 1306813316) is an individual internal medicine provider in Lake In The Hills, Illinois, licensed in Illinois (036078681) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Advocate Sherman Hospital, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1306813316

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJAMES NIKOLEITCredential: MD

Location Address170 NORTH LAKEWOOD ROADLake In The Hills, IL 60156-5945

Mailing Address170 North Lakewood RoadLake In The Hills, IL 60156-5945 · (224) 569-4000 · Fax (224) 569-4001

Phone(224) 569-4000

Fax(224) 569-4001

Sole ProprietorNo

Medical School CMSOtherGraduated 1986

Enumeration DateMarch 8, 2006

Last NPPES UpdateAugust 31, 20222 updates tracked since enumeration

NPPES CertifiedAugust 31, 2022

✔ NPI 1306813316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036078681

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.

170 NORTH LAKEWOOD ROAD, Lake In The Hills, IL 60156

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Other Identifiers 1

Medicaid036078681IL

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 Nikoleit Md 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 ID3173418621

PECOS Enrollment IDI20040216000477

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 24

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 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.

686 services284 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

149 services149 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

120 services98 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.

110 services93 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

70 services47 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

69 services65 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

57 services41 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

46 services38 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

43 services43 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

42 services42 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

31 services27 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.

30 services25 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.

29 services29 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

29 services29 patients

Stool analysis for blood to screen for colon tumors 82270

A stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.

26 services26 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

26 services23 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.

19 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

18 services18 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

18 services18 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

15 services15 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

15 services13 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

15 services15 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

13 services13 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Advocate Sherman Hospital

Acute Care Hospitals · Elgin, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140030

Location1425 North Randall RoadElgin, IL 60123 · Kane County

Emergency services Birthing friendly

Northwestern Medicine Mchenry

Acute Care Hospitals · Mchenry, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140116

Location4201 Medical Center DriveMchenry, IL 60050 · Mc Henry County

Emergency services Birthing friendly

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Advocate Good Shepherd Hospital

Acute Care Hospitals · Barrington, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140291

Location450 West Highway 22Barrington, IL 60010 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60156 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

69.02/100

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

Individually scored

Quality

77.67

Promoting Interoperability

Improvement Activities

Cost

19.89

Reported Quality Measures

Advance Care Plan

99%523 patients4/55-star benchmark: 100%

Colorectal Cancer Screening

13%1,053 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

80%535 patients4/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

19%175 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

90%4,402 patients4/55-star benchmark: 100%

e-Prescribing

96%2,075 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

5%541 patients1/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

40%1,659 patients2/55-star benchmark: 97%

Provide Patients Electronic Access to Their Health Information

100%958 patients5/55-star benchmark: 100%

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 3

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

9 suppliers24 claims68 services$5.92 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers16 claims19 services$0.89 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$214.09 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 6

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

DR. GEORGE WILLIAM URBAN M.D.

Internal Medicine