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JAMES PAUL CAPLAN MD
NPI 1356474175
Family Medicine in Houston, TX

Active since March 13, 2007PECOS Enrolled
1234 CAMPTON CT, HOUSTON, TX 77055(713) 444-8960(346) 639-2040 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 5, 2025, Mar 17, 2018, Dec 28, 2017 (3 updates tracked since 2017).

About James Paul Caplan Md NPPES

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

JAMES PAUL CAPLAN MD (NPI 1356474175) is an individual family medicine provider in Houston, Texas, licensed in Texas (H1349) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in League City.

NPPES Registry Identity

NPI1356474175
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES PAUL CAPLANCredential: MD
Location Address1234 CAMPTON CTHouston, TX 77055-7007
Mailing Address1234 Campton CtHouston, TX 77055-7007 · (713) 444-8960 · Fax (346) 639-2040
Phone(713) 444-8960
Fax(346) 639-2040
Sole ProprietorYes
Enumeration DateMarch 13, 2007
Last NPPES UpdateDecember 5, 20253 updates tracked since enumeration
NPPES CertifiedDecember 5, 2025
✔ NPI 1356474175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · H1349
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNuclear MedicineTaxonomy 207U00000X · License H1349 (TX), 2017026099 (MO), ME133775 (FL), 169670 (NY)
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 169670 (NY), ME133775 (FL), 2017026099 (MO)
Also ListedNuclear Medicine · Nuclear Imaging & TherapyTaxonomy 207UN0902X · License 2017026099 (MO), 169670 (NY), ME133775 (FL), H1349 (TX)
Also ListedNuclear Medicine · In Vivo & In Vitro Nuclear MedicineTaxonomy 207UN0903X · License H1349 (TX)
1234 CAMPTON CT, Houston, TX 77055
Open in Google Maps ↗

Secondary Practice Location 1

Location 12785 Gulf Fwy S Ste 115League City, TX 77573-4989 · Phone (832) 738-1913 · Fax (281) 991-3800

Other Identifiers 1

Medicaid171700101AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Paul Caplan Md 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.

Medicare Billing Reassignments

9

Medicare enrollment records show James Caplan reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

South Hampton Medical Imaging, LLC
8.1 mi
Diagnostic Radiology
7707 FANNIN ST STE 159
Houston, TX 77054
  • Reassigned Medicare billing, Texas enrollment
  • 2 clinicians in this Medicare group
NPI 1386422293 (832) 202-8176
Merit Radiology PLLC
238 mi
Diagnostic Radiology
4343 N JOSEY LN
Carrollton, TX 75010
  • Reassigned Medicare billing, Texas enrollment
  • 68 clinicians in this Medicare group
NPI 1326819145 (972) 492-1010
Uvalde County Hospital Authority
261 mi
Rural Health
1800 GARNER FIELD RD
Uvalde, TX 78801
  • Reassigned Medicare billing, Texas enrollment
  • 47 clinicians in this Medicare group
NPI 1689490211 (830) 278-4453
Maverick County Rural Radiologists P A
310 mi
Diagnostic Radiology
3333 N FOSTER MALDONADO BLVD
Eagle Pass, TX 78852
  • Reassigned Medicare billing, Texas enrollment
  • 13 clinicians in this Medicare group
NPI 1437117181 (830) 773-5321
Simonmed Imaging Florida LLC
796 mi
Diagnostic Radiology
14302 BRUCE B DOWNS BLVD
Tampa, FL 33613
  • Reassigned Medicare billing, Texas enrollment
  • 32 clinicians in this Medicare group
NPI 1477830818 (813) 979-7580
Imaging Associates Of Indiana, PC
873 mi
Diagnostic Radiology
2001 W 86TH ST
Indianapolis, IN 46260
  • Reassigned Medicare billing, Texas enrollment
  • 68 clinicians in this Medicare group
NPI 1699072611 (219) 767-6320
Smi Imaging, LLC
1,002 mi
Diagnostic Radiology
6740 E CAMELBACK RD STE 100
Scottsdale, AZ 85251
  • Reassigned Medicare billing, Texas enrollment
  • 57 clinicians in this Medicare group
NPI 1972004489 (602) 651-1945
Howard John Simon MD PC
1,426 mi
Diagnostic Radiology
170 E 77TH ST LOWR LEVEL
New York, NY 10075
  • Reassigned Medicare billing, Texas enrollment
  • 11 clinicians in this Medicare group
NPI 1932768934 (212) 369-9200
Health Diagnostics Of California A Professional Corporation
1,615 mi
Diagnostic Radiology
105 SOUTH DR STE 110
Mountain View, CA 94040
  • Reassigned Medicare billing, Texas enrollment
  • 16 clinicians in this Medicare group
NPI 1104321959 (650) 259-3165

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77055 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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

Reported Quality Measures

Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy
Percentage of final reports for all patients, regardless of age, undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MRI, CT, etc.) that were performed
100%45 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.

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 Caplan's NPI number?

The NPI number for James Caplan is 1356474175. It was assigned to this individual provider in the NPPES registry on March 13, 2007.

Where is James Caplan located?

James Caplan practices at 1234 Campton Ct, Houston, TX 77055. The listed phone number is (713) 444-8960.

What is James Caplan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Caplan enrolled in Medicare?

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

Which organizations bill Medicare for James Caplan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Caplan reassigns Medicare benefits to 9 organizations: South Hampton Medical Imaging, LLC (Houston, TX), Merit Radiology PLLC (Carrollton, TX), Uvalde County Hospital Authority (Uvalde, TX), Maverick County Rural Radiologists P A (Eagle Pass, TX), Simonmed Imaging Florida LLC (Tampa, FL) and 4 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Caplan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Caplan accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health and Blue Cross and Blue Shield of Texas list James Caplan 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 Caplan was last updated on December 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.