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

NPI Status: Active since March 13, 2007

Contact Information

1234 CAMPTON CT
HOUSTON, TX
ZIP 77055
Phone: (713) 444-8960
Fax: (346) 639-2040

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  • Individual
  • Male
  • Family Medicine
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About JAMES CAPLAN

This page provides the complete NPI Profile along with additional information for James Caplan, a primary care provider established in Houston, Texas with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1356474175 assigned on March 2007. The practitioner's primary taxonomy code is 207Q00000X with license number H1349 (TX). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1356474175
Provider Name
JAMES PAUL CAPLAN MD
Gender
Male
Entity Type
Individual
Location Address
1234 CAMPTON CT HOUSTON, TX 77055
Location Phone
(713) 444-8960
Location Fax
(346) 639-2040
Mailing Address
1234 CAMPTON CT HOUSTON, TX 77055
Mailing Phone
(713) 444-8960
Mailing Fax
(346) 639-2040
Is Sole Proprietor?
Yes
Enumeration Date
03-13-2007
Last Update Date
12-05-2025
Code Navigator

A primary care provider (PCP) like James Caplan sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 2785 Gulf Fwy S Ste 115
    League City, TX 77573
    (832) 738-1913

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
H1349
License State
TX
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207U00000XAllopathic & Osteopathic Physicians

Nuclear Medicine

H1349 (TX)
2207U00000XAllopathic & Osteopathic Physicians

Nuclear Medicine

2017026099 (MO)
3207U00000XAllopathic & Osteopathic Physicians

Nuclear Medicine

ME133775 (FL)
4207U00000XAllopathic & Osteopathic Physicians

Nuclear Medicine

169670 (NY)
5207UN0901XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Cardiology

169670 (NY)
6207UN0901XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Cardiology

ME133775 (FL)
7207UN0901XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Cardiology

2017026099 (MO)
8207UN0902XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Imaging & Therapy

2017026099 (MO)
9207UN0902XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Imaging & Therapy

169670 (NY)
10207UN0902XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Imaging & Therapy

ME133775 (FL)
11207UN0902XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Imaging & Therapy

H1349 (TX)
12207UN0903XAllopathic & Osteopathic Physicians

Nuclear Medicine
In Vivo & In Vitro Nuclear Medicine

H1349 (TX)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
171700101MEDICAID (05)AR 

Medicare Participation & PECOS Enrollment Status

James Caplan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 65 times for 65 patients

Injection of drug or substance into vein

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

This service was performed 45 times for 45 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 12 times for 12 patients

Nuclear medicine study of bone and/or joint whole body

A nuclear medicine study of bone and/or joint whole body involves injecting a small amount of radioactive material into your body. This material travels to your bones and emits energy. A special camera captures this energy, creating images of your bones to help identify any abnormalities.

This service was performed 38 times for 38 patients

Nuclear medicine study of bone taken at different times

A nuclear medicine bone study involves injecting a small amount of radioactive material into your body. This material collects in the bones and is detected by a special camera to create images. These images are taken at different times to track changes and help diagnose bone conditions.

This service was performed 38 times for 38 patients

Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries

Technetium Tc-99m Medronate is a diagnostic procedure that uses a small amount of radioactive material to examine the health of your bones. It helps to detect bone diseases or abnormalities. The procedure is safe, with the radioactive substance naturally leaving your body after the test.

This service was performed 38 times for 38 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 77055 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $90.4
  • Minimum New Patient Price $58.24
  • Maximum New Patient Price $176.98
  • Average New Patient Copayment $22.6
  • Minimum New Patient Copayment $14.56
  • Maximum New Patient Copayment $44.24

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.71
  • Minimum Established Patient Price $18.6
  • Maximum Established Patient Price $143.93
  • Average Established Patient Copayment $25.67
  • Minimum Established Patient Copayment $4.65
  • Maximum Established Patient Copayment $35.98

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients

Reviews for JAMES PAUL CAPLAN MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1356474175, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 4 → 8 4 → 8 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 0 + 6 + 8 + 7 + 8 + 1 + 1 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1356474175.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356474175, enumerated as an "individual" on March 13, 2007.

The provider is located at 1234 CAMPTON CT HOUSTON, TX 77055 and the phone number is (713) 444-8960.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Medicare and. Please consult your insurance carrier or call the provider to verify.