JAMES T GUILLE M.D.
NPI 1346218237
Orthopaedic Surgery in Pottstown, PA

Q: What is James Guille's NPI number?

The NPI number for James Guille is 1346218237. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Q: What is James Guille'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 Guille was last updated on January 16, 2014. 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.

Active since March 08, 2006PECOS EnrolledAccepts Medicare Assignment

66.04/100

CMS Quality Rating

1561 MEDICAL DR., POTTSTOWN, PA 19464(610) 792-9292(610) 792-9293 Get Directions Write a Review

NPPES record last updated: January 16, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About James T Guille M.d. NPPES

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

JAMES T GUILLE M.D. (NPI 1346218237) is an individual orthopaedic surgery provider in Pottstown, Pennsylvania, licensed in Pennsylvania (MD069514L) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Pottstown Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1346218237

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameJAMES T GUILLECredential: M.D.

Location Address1561 MEDICAL DR.Pottstown, PA 19464

Mailing Address1561 Medical Dr.Pottstown, PA 19464 · (610) 792-9292 · Fax (610) 792-9293

Phone(610) 792-9292

Fax(610) 792-9293

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateMarch 8, 2006

Last NPPES UpdateJanuary 16, 2014

✔ NPI 1346218237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in PA · MD069514L✔ Licensed in DE · CL-0006605

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.

1561 MEDICAL DR., Pottstown, PA 19464

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware.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 T Guille 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 ID8921082884

PECOS Enrollment IDI20040617000212

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 18

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.

438 services56 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.

152 services108 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.

85 services85 patients

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.

63 services60 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.

61 services38 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.

51 services51 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

32 services26 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.

28 services22 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

27 services20 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

24 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

24 services24 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

24 services16 patients

X-ray lower and sacral spine, minimum of 6 views 72114

An X-ray of the lower and sacral spine involves capturing images of the bones in your lower back and tailbone area. It helps to identify issues like fractures, infections, or degenerative diseases. A minimum of 6 views ensures a comprehensive examination.

21 services21 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

19 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

19 services19 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

18 services17 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.

18 services13 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

16 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390123

Location1600 East High StreetPottstown, PA 19464 · Montgomery County

Emergency services

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number390127

Location140 Nutt RoadPhoenixville, PA 19460 · Chester County

Emergency services Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390179

Location701 East Marshall StreetWest Chester, PA 19380 · Chester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19464 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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.

66.04/100

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

Individually scored

Quality

60.05

Improvement Activities

Reported Quality Measures

Colorectal Cancer Screening

0%935 patients1/55-star benchmark: 88%

Documentation of Current Medications in the Medical Record

94%3,050 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

14%503 patients1/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%2,399 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 61% · 1,495 patients

Patients screened: 63% · 1,495 patients

48%33 patients2/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

87%98 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 535 patients

Patients totalRate: 0% · 535 patients

0%535 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.

Other Providers at the Same Location NPPES

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

LINDA PARK D'ANDREA M.D.

Orthopaedic Surgery

1561 MEDICAL DR.
POTTSTOWN, PA 19464

Montgomery County (610) 792-9292

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 Guille's NPI number?

The NPI number for James Guille is 1346218237. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Where is James Guille located?

James Guille practices at 1561 Medical Dr., Pottstown, PA 19464. The listed phone number is (610) 792-9292.

What is James Guille's specialty?

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

Is James Guille enrolled in Medicare?

Yes. James Guille 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 Guille accept?

Health plans from Highmark Blue Cross Blue Shield Delaware list James Guille 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 Guille affiliated with any hospitals?

According to CMS data, James Guille is affiliated with Pottstown Hospital, Phoenixville Hospital and Chester County Hospital.

When was this NPI record last updated?

The NPPES record for James Guille was last updated on January 16, 2014. 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.