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DR. SEAN WILLIAM JAMES D.O.
NPI 1356729438
Family Medicine in Corbin, KY

Active since May 11, 2015PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
14949 N US HIGHWAY 25 E STE 4, CORBIN, KY 40701(606) 528-0305(606) 523-4368 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 7, 2020, Jan 23, 2017 (2 updates tracked since 2017).

About Dr. Sean William James D.o. NPPES

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

DR. SEAN WILLIAM JAMES D.O. (NPI 1356729438) is an individual family medicine provider in Corbin, Kentucky, licensed in Kentucky (TP581) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Corbin, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1356729438
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SEAN WILLIAM JAMESCredential: D.O.
Location Address14949 N US HIGHWAY 25 E STE 4Corbin, KY 40701
Mailing AddressPo Box 1325Corbin, KY 40702-1325 · (606) 526-8131 · Fax (606) 528-8661
Phone(606) 528-0305
Fax(606) 523-4368
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateMay 11, 2015
Last NPPES UpdateDecember 7, 20202 updates tracked since enumeration
NPPES CertifiedDecember 7, 2020
✔ NPI 1356729438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · TP581
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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
14949 N US HIGHWAY 25 E STE 4, Corbin, KY 40701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Dr. Sean William 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 ID7719282110
PECOS Enrollment IDI20180605002706
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 3

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.

X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
24 services19 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
15 services11 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
14 services13 patients

Hospital Affiliations CMS Care Compare

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

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180080
LocationOne Trillium WayCorbin, KY 40701 · Whitley County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40701 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

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
9 suppliers37 claims85 services$5.56 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier11 claims11 services$923.20 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
2 suppliers32 claims32 services$119.67 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$35.01 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
6 suppliers13 claims13 services$23.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Sean James's NPI number?

The NPI number for Sean James is 1356729438. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Sean James located?

Sean James practices at 14949 N Us Highway 25 E Ste 4, Corbin, KY 40701. The listed phone number is (606) 528-0305.

What is Sean James's specialty?

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

Is Sean James enrolled in Medicare?

Yes. Sean 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.

What insurance does Sean James accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Sean 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 Sean James affiliated with any hospitals?

According to CMS data, Sean James is affiliated with Baptist Health Corbin.

When was this NPI record last updated?

The NPPES record for Sean James was last updated on December 7, 2020. 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.