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DR. JAMES PATRICK O'NEAL MD
NPI 1376527218
Otolaryngology in Conroe, TX

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
508 MEDICAL CENTER BLVD, CONROE, TX 77304(936) 523-1422(936) 523-1440 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. James Patrick O'neal Md NPPES

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

DR. JAMES PATRICK O'NEAL MD (NPI 1376527218) is an individual otolaryngology provider in Conroe, Texas, licensed in Texas (M1272) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Hca Houston Healthcare Conroe, and is a graduate of Baylor College Of Medicine (2000).

NPPES Registry Identity

NPI1376527218
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. JAMES PATRICK O'NEALCredential: MD
Location Address508 MEDICAL CENTER BLVDConroe, TX 77304-2953
Mailing Address508 Medical Center BlvdConroe, TX 77304-2953 · (936) 523-1422 · Fax (936) 523-1440
Phone(936) 523-1422
Fax(936) 523-1440
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 2000
Enumeration DateDecember 5, 2005
Last NPPES UpdateFebruary 8, 2022
✔ NPI 1376527218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in TX · M1272
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
508 MEDICAL CENTER BLVD, Conroe, TX 77304
Open in Google Maps ↗

Other Identifiers 6

Other8CA306TX · Bcbs-sadler
Other094010801TX · Medicaid Group-sadler
Other10035579Amerigroup
Other207Y00000XTaxonomy
Other1114979127TX · Npi Group-sadler
Other741763675TX · Tax Id - Sadler

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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. James Patrick O'neal 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 ID1052340379
PECOS Enrollment IDI20050808000459
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 8

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 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.
306 services209 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
155 services102 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
75 services75 patients
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268
This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.
70 services70 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
44 services37 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
38 services34 patients

Hospital Affiliations CMS Care Compare

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

Hca Houston Healthcare Conroe

Acute Care Hospitals · Conroe, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450222
Location504 Medical Center BlvdConroe, TX 77304 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77304 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

e-Prescribing
98%555 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
100%833 patients5/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers21 claims21 services$32.85 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers12 claims12 services$68.97 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers12 claims34 services$27.52 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers13 claims13 services$14.02 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers21 claims125 services$1.59 avg. paid by Medicare
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
1 supplier12 claims12 services$73.97 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.

MS. MARIE ELIZABETH CANTRELL OT-C
508 MEDICAL CENTER BLVD
CONROE, TX 77304
Montgomery County (936) 521-7374
JAMES DWAYNE PICKETT MD
Internal Medicine (Interventional Cardiology)
508 MEDICAL CENTER BLVD, STE 200
CONROE, TX 77304
Montgomery County (936) 760-4600
LABORATORY CORPORATION OF AMERICA
Clinical Medical Laboratory
508 MEDICAL CENTER BLVD
CONROE, TX 77304
Montgomery County (936) 760-4600
DR. VICTORIA M ADELEYE MD
Family Medicine
508 MEDICAL CENTER BLVD, STE 200
CONROE, TX 77304
Montgomery County (936) 760-4600
MRS. LAUREN MORGAN HOLLIS PA-C
Physician Assistant
508 MEDICAL CENTER BLVD, STE 200
CONROE, TX 77304
Montgomery County (936) 760-4600
ANJALI DASGUPTA MD
Internal Medicine (Infectious Disease)
508 MEDICAL CENTER BLVD
CONROE, TX 77304
Montgomery County (936) 523-1701
GEORGE STEVEN BOYLE MD
Internal Medicine (Cardiovascular Disease)
508 MEDICAL CENTER BLVD, STE 200
CONROE, TX 77304
Montgomery County (936) 760-4600
TRACEY TEBBE GRAPPE PA
Physician Assistant (Medical)
508 MEDICAL CENTER BLVD
CONROE, TX 77304
Montgomery County (936) 760-8528

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 O'neal's NPI number?

The NPI number for James O'neal is 1376527218. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is James O'neal located?

James O'neal practices at 508 Medical Center Blvd, Conroe, TX 77304. The listed phone number is (936) 523-1422.

What is James O'neal's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James O'neal enrolled in Medicare?

Yes. James O'neal 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 James O'neal accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 7 other insurers list James O'neal 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 O'neal affiliated with any hospitals?

According to CMS data, James O'neal is affiliated with Hca Houston Healthcare Conroe.

When was this NPI record last updated?

The NPPES record for James O'neal was last updated on February 8, 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.