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JAMES P. GIERAHN M.D.
NPI 1306870696
Internal Medicine - Geriatric Medicine in Racine, WI

Active since July 10, 2006PECOS Enrolled
82.39/100
CMS Quality Rating

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About James P. Gierahn M.d. NPPES

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

JAMES P. GIERAHN M.D. (NPI 1306870696) is an individual geriatric medicine provider in Racine, Wisconsin, licensed in Wisconsin (21389) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306870696
Entity TypeIndividualMale
Primary Taxonomy207RG0300X
Provider Legal NameJAMES P. GIERAHNCredential: M.D.
Location Address1 MAIN STRacine, WI 53403-1079
Mailing Address1 Main StRacine, WI 53403-1079 · (262) 687-6100
Phone(262) 687-6100
Sole ProprietorNo
Enumeration DateJuly 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1306870696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in WI · 21389
Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

1 MAIN ST, Racine, WI 53403
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINB53062

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James P. Gierahn M.d. 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.

Areas of Expertise CMS Part B claims 7

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, 30-39 minutes 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.
256 services139 patients
Follow-up nursing facility visit per day, typically 25 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
208 services99 patients
Initial nursing facility visit per day, typically 45 minutes 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
95 services88 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.
73 services73 patients
Established patient office or other outpatient visit, 20-29 minutes 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.
26 services26 patients
Initial nursing facility visit per day, typically 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53403 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.88
Promoting Interoperability81
Improvement Activities40
Cost74.38

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
6 suppliers20 claims69 services$6.05 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers11 claims11 services$40.43 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers15 claims90 services$2.14 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers24 claims24 services$15.61 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
3 suppliers25 claims25 services$79.60 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers21 claims21 services$12.99 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 5

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

SUZANNE L. COOPER N.P.
Nurse Practitioner (Gerontology)
1 MAIN ST
RACINE, WI 53403
Racine County (262) 687-6100
JUDITH A. BAGLEY N.P.
Nurse Practitioner (Adult Health)
1 MAIN ST
RACINE, WI 53403
Racine County (262) 687-6100
DANIEL B. ROSS M.D.
Internal Medicine
1 MAIN ST
RACINE, WI 53403
Racine County (262) 687-6100
SUSAN NOSALIK NP
Nurse Practitioner
1 MAIN ST
RACINE, WI 53403
Racine County (262) 687-6100
GERALD WISNIEWSKI MD
Internal Medicine
1 MAIN ST
RACINE, WI 53403
Racine County (262) 687-6100

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 Gierahn's NPI number?

The NPI number for James Gierahn is 1306870696. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is James Gierahn located?

James Gierahn practices at 1 Main St, Racine, WI 53403. The listed phone number is (262) 687-6100.

What is James Gierahn's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is James Gierahn enrolled in Medicare?

Yes. James Gierahn is registered in the Medicare PECOS enrollment system.

What insurance does James Gierahn accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list James Gierahn 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 Gierahn was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.