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JAMES MACDONALD MD
NPI 1366526469
Family Medicine in Nashville, TN

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment
97.12/100
CMS Quality Rating

NPPES record last updated: March 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About James Macdonald Md NPPES

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

JAMES MACDONALD MD (NPI 1366526469) is an individual family medicine provider in Nashville, Tennessee, licensed in Tennessee (MD29564) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Williamson Medical Center, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1366526469
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES MACDONALDCredential: MD
Location Address3601 TVCNashville, TN 37232-0001
Mailing Address3841 Green Hills Village Dr Ste 200Nashville, TN 37215-2691 · (615) 936-2000
Phone(615) 322-3000
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateOctober 25, 2006
Last NPPES UpdateMarch 21, 2022
NPPES CertifiedMarch 21, 2022
✔ NPI 1366526469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · MD29564
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.
3601 TVC, Nashville, TN 37232
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., BlueCross BlueShield of Tennessee, Cigna Healthcare 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

James Macdonald Md 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 ID7911800883
PECOS Enrollment IDI20040128001020
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 James Macdonald reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vanderbilt University Medical Center
3.0 mi
Internal Medicine
1301 22ND AVE S
Nashville, TN 37232
  • Reassigned Medicare billing, Tennessee enrollment
  • 4,711 clinicians in this Medicare group
NPI 1104202761 (615) 936-2000
Vanderbilt Health And Williamson Medical Center Clinics And Services,
19 mi
Internal Medicine
919 MURFREESBORO RD
Franklin, TN 37064
  • Reassigned Medicare billing, Tennessee enrollment
  • 298 clinicians in this Medicare group
NPI 1225135551 (615) 591-9890

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 9

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.
266 services164 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
173 services173 patients
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.
132 services16 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
80 services79 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
67 services67 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Williamson Medical Center

Acute Care Hospitals · Franklin, TN
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440029
Location4321 Carothers ParkwayFranklin, TN 37067 · Williamson County
Emergency services Birthing friendly

Vanderbilt University Medical Center

Acute Care Hospitals · Nashville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440039
Location1211 Medical Center DriveNashville, TN 37232 · Davidson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37232 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

97.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.64
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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
19 suppliers44 claims137 services$5.62 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers19 claims28 services$1.02 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

GEORGE ANNE RAINES APRN
Pediatrics
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
LEALANI MAE ACOSTA MD
Psychiatry & Neurology (Neurology)
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
ELLEN HOUSE MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
DR. DEBORAH P JONES MD
Pediatrics (Pediatric Nephrology)
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
SPYROS KALAMS MD
Internal Medicine (Infectious Disease)
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
ROBERT BAUM MD
Physical Medicine & Rehabilitation
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
KENNETH SHARP MD
Surgery
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000
JOHN DOWNING MD
Anesthesiology
3601 TVC
NASHVILLE, TN 37232
Davidson County (615) 322-3000

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 Macdonald's NPI number?

The NPI number for James Macdonald is 1366526469. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is James Macdonald located?

James Macdonald practices at 3601 Tvc, Nashville, TN 37232. The listed phone number is (615) 322-3000.

What is James Macdonald's specialty?

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

Is James Macdonald enrolled in Medicare?

Yes. James Macdonald 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 James Macdonald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Macdonald reassigns Medicare benefits to 2 organizations: Vanderbilt University Medical Center (Nashville, TN) and Vanderbilt Health And Williamson Medical Center Clinics And Services, (Franklin, TN). 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 Macdonald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Macdonald accept?

Health plans from Alliant Health Plans, Inc., BlueCross BlueShield of Tennessee, Cigna Healthcare and Oscar Insurance Company list James Macdonald 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 Macdonald affiliated with any hospitals?

According to CMS data, James Macdonald is affiliated with Williamson Medical Center and Vanderbilt University Medical Center.

When was this NPI record last updated?

The NPPES record for James Macdonald was last updated on March 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.