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DR. SARAH JEAN JAMES D.O.
NPI 1356514160
Family Medicine in Verona, WI

Active since April 12, 2008PECOS EnrolledAccepts Medicare Assignment
100 N NINE MOUND RD, VERONA, WI 53593(608) 845-9531(608) 845-8684 Get Directions Write a Review

NPPES record last updated: March 31, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Sarah Jean James D.o. NPPES

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

DR. SARAH JEAN JAMES D.O. (NPI 1356514160) is an individual family medicine provider in Verona, Wisconsin, licensed in Wisconsin (54100) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1356514160
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SARAH JEAN JAMESCredential: D.O.
Location Address100 N NINE MOUND RDVerona, WI 53593-1032
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Phone(608) 845-9531
Fax(608) 845-8684
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateApril 12, 2008
Last NPPES UpdateMarch 31, 2021
NPPES CertifiedMarch 31, 2021
✔ NPI 1356514160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 54100
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.
100 N NINE MOUND RD, Verona, WI 53593
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Dean Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sarah Jean James D.o. 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 ID2668636788
PECOS Enrollment IDI20120620000802
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

2

Medicare enrollment records show Sarah James reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Wisconsin Medical Foundation, Inc
7.9 mi
Multi-Specialty
7974 UW HEALTH COURT
Middleton, WI 53562
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,832 clinicians in this Medicare group
NPI 1598784555 (608) 829-5485
Access Community Health Centers, Inc.
8.6 mi
Federally Qualified Health Center (FQHC)
2202 S PARK ST
Madison, WI 53713
  • Reassigned Medicare billing, Wisconsin enrollment
  • 124 clinicians in this Medicare group
NPI 1568675858 (608) 443-5500

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

Areas of Expertise CMS Part B claims 4

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.
78 services50 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
60 services39 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.
53 services33 patients
Osteopathic manipulative treatment, 1-2 body regions 98925
Osteopathic Manipulative Treatment (OMT) is a hands-on method where doctors use their hands to diagnose and treat illnesses. For 1-2 body regions, the doctor focuses on specific areas like your back or neck, using techniques to alleviate pain, restore function, and promote healing.
14 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53593 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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.

Other Providers at the Same Location NPPES 20

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

JENNIFER E SVARVERUD D.O.
Family Medicine
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
DR. MARK WILLIAM WIRTZ
Family Medicine
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
MICHAEL GILLCRIST PT
Physical Therapist
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-1955
AMY KATHERINE HOLZER MD
Student in an Organized Health Care Education/Training Program
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Durable Medical Equipment & Medical Supplies
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
ALLISON D COUTURE DO
Family Medicine
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
SARA EIMERMANN LOEVINGER DPT
Physical Therapist
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531
SUPRIYA PAIDEMARRY MD
Student in an Organized Health Care Education/Training Program
100 N NINE MOUND RD
VERONA, WI 53593
Dane County (608) 845-9531

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 Sarah James's NPI number?

The NPI number for Sarah James is 1356514160. It was assigned to this individual provider in the NPPES registry on April 12, 2008.

Where is Sarah James located?

Sarah James practices at 100 N Nine Mound Rd, Verona, WI 53593. The listed phone number is (608) 845-9531.

What is Sarah James's specialty?

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

Is Sarah James enrolled in Medicare?

Yes. Sarah James 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.

Which organizations bill Medicare for Sarah James's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sarah James reassigns Medicare benefits to 2 organizations: University Of Wisconsin Medical Foundation, Inc (Middleton, WI) and Access Community Health Centers, Inc. (Madison, WI). 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 Sarah James's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sarah James accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Dean Health Plan, Group Health Cooperative-SCW and HealthPartners and 2 other insurers list Sarah James 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 Sarah James affiliated with any hospitals?

According to CMS data, Sarah James is affiliated with Ssm Health St Mary's Hospital - Madison and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Sarah James was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.