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DR. JAMES L CLEMENS M.D.
NPI 1427043744
Family Medicine in Orange City, IA

Active since September 13, 2005PECOS EnrolledAccepts Medicare Assignment
83.57/100
CMS Quality Rating
1000 LINCOLN CIR SE, SUITE 100, ORANGE CITY, IA 51041(712) 737-2000(712) 737-2115 Get Directions Write a Review

NPPES record last updated: February 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James L Clemens M.d. NPPES

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

DR. JAMES L CLEMENS M.D. (NPI 1427043744) is an individual family medicine provider in Orange City, Iowa, licensed in Iowa (23103) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Orange City Area Health System, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1981).

NPPES Registry Identity

NPI1427043744
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES L CLEMENSCredential: M.D.
Location Address1000 LINCOLN CIR SE, SUITE 100Orange City, IA 51041-1862
Mailing Address1000 Lincoln Cir Se, Suite 100Orange City, IA 51041-1862 · (712) 737-2000 · Fax (712) 737-2115
Phone(712) 737-2000
Fax(712) 737-2115
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1981
Enumeration DateSeptember 13, 2005
Last NPPES UpdateFebruary 2, 2023
NPPES CertifiedFebruary 2, 2023
✔ NPI 1427043744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IA · 23103
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.
1000 LINCOLN CIR SE, Orange City, IA 51041
Open in Google Maps ↗

Other Identifiers 16

Other0117544IA · Medica
Other29165IA · Wellmark Bcbs Clinic Loc
Other171IA · Midlands Choice
Other42603840551041IA · Wps Tricare
Medicaid0012815IA
Other080110809IA · Railroad Medicare
Other46878IA · Bc/bs Er Location
Other0117544IA · United Healthcare
Other703361023655IN · Preferred One
OtherA02341IA · Coventry Health Care
Other21984IA · Sioux Valley Health Plan
Other29165IA · First Administrators
Other3654IA · Avera Health Plan
Other9173649IA · Dakotacare
Medicaid2012815IA
Other426038405IA · Cigna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan 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 L Clemens M.d. 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 ID7618987991
PECOS Enrollment IDI20060502000060
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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
48 services24 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
28 services11 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
22 services16 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Orange City Area Health System

Critical Access Hospitals · Orange City, IA
OwnershipVoluntary non-profit - Other
CMS Certification Number161360
Location1000 Lincoln Circle SEOrange City, IA 51041 · Sioux County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 51041 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $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.

83.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.07
Promoting Interoperability98
Improvement Activities40
Cost50.83

Referred Medical Equipment & Supplies CMS DME claims 9

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
4 suppliers28 claims55 services$5.87 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers12 claims12 services$70.11 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers16 claims16 services$24.98 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers19 claims90 services$3.22 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
3 suppliers19 claims19 services$18.82 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
4 suppliers32 claims32 services$51.99 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.

ORANGE CITY MUNICIPAL HOSPITAL
Emergency Medicine
1000 LINCOLN CIR SE
ORANGE CITY, IA 51041
Sioux County (712) 737-4984
MS. GLENDA M ALTENA ARNP
Nurse Practitioner (Family)
1000 LINCOLN CIR SE, SUITE 100
ORANGE CITY, IA 51041
Sioux County (712) 737-2000
DR. MARK W MUILENBURG M.D.
Family Medicine
1000 LINCOLN CIR SE, SUITE 100
ORANGE CITY, IA 51041
Sioux County (712) 737-2000
KIMBERLY GOSLINGA ARNP
Nurse Practitioner (Psychiatric/Mental Health)
1000 LINCOLN CIR SE
ORANGE CITY, IA 51041
Sioux County (712) 737-2000
DR. CYNTHIA M PALS M.D.
Family Medicine
1000 LINCOLN CIR SE, SUITE 100
ORANGE CITY, IA 51041
Sioux County (712) 737-2000
HARRISON H HANSON MD
Family Medicine
1000 LINCOLN CIR SE, SUITE 100
ORANGE CITY, IA 51041
Sioux County (712) 737-4984
BRADLEY ZWART
Physical Therapist
1000 LINCOLN CIR SE, SUITE 400
ORANGE CITY, IA 51041
Sioux County (712) 737-5234
THERAPEUTIC HEALTH SERVICES, INC
Clinic/Center (Physical Therapy)
1000 LINCOLN CIR SE, SUITE 400
ORANGE CITY, IA 51041
Sioux County (712) 737-5234

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 Clemens's NPI number?

The NPI number for James Clemens is 1427043744. It was assigned to this individual provider in the NPPES registry on September 13, 2005.

Where is James Clemens located?

James Clemens practices at 1000 Lincoln Cir SE Suite 100, Orange City, IA 51041. The listed phone number is (712) 737-2000.

What is James Clemens's specialty?

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

Is James Clemens enrolled in Medicare?

Yes. James Clemens 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 Clemens accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 3 other insurers list James Clemens 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 Clemens affiliated with any hospitals?

According to CMS data, James Clemens is affiliated with Orange City Area Health System.

When was this NPI record last updated?

The NPPES record for James Clemens was last updated on February 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.