1. Home
  2. Directory
  3. Connecticut
  4. New Haven
  5. Internal Medicine
  6. NPI Profile

DR. JAMES DORAN MD
NPI 1437682481
Internal Medicine in New Haven, CT

Active since April 06, 2017PECOS EnrolledAccepts Medicare Assignment
93.27/100
CMS Quality Rating
20 YORK ST, CB2041, NEW HAVEN, CT 06510(203) 688-4748(203) 688-4740 Get Directions Write a Review

NPPES record last updated: August 10, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 10, 2023, Sep 18, 2020 (2 updates tracked since 2020).

About Dr. James Doran Md NPPES

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

DR. JAMES DORAN MD (NPI 1437682481) is an individual internal medicine provider in New Haven, Connecticut, licensed in Connecticut (75533) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2017).

NPPES Registry Identity

NPI1437682481
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JAMES DORANCredential: MD
Location Address20 YORK ST, CB2041New Haven, CT 06510-3220
Mailing Address20 York St, Cb2041New Haven, CT 06510-3220 · (203) 688-4748 · Fax (203) 688-4740
Phone(203) 688-4748
Fax(203) 688-4740
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2017
Enumeration DateApril 6, 2017
Last NPPES UpdateAugust 10, 20232 updates tracked since enumeration
NPPES CertifiedAugust 10, 2023
✔ NPI 1437682481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in CT · 75533✔ Licensed in MD · D89778
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
20 YORK ST, New Haven, CT 06510
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12401 W Belvedere AveBaltimore, MD 21215-5216 · Phone (410) 601-0594 · Fax (410) 601-0939
Location 22150 Pennsylvania Ave NW, The GW Medical Faculty AssociatesWashington, DC 20037-3201 · Phone (202) 741-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. James Doran 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 ID2961774708
PECOS Enrollment IDI20230825002809
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 Doran reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mill Hill Medical Consultants Inc
Same address
Hospitalist
20 YORK ST, CB 2041
New Haven, CT 06510
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Northeast Medical Group Inc
  • 1,824 clinicians in this Medicare group
NPI 1952624769 (203) 688-4741
Sinai Hospital Of Baltimore Inc
234 mi
Infectious Disease
849 FAIRMOUNT AVE STE 100B
Towson, MD 21286
  • Reassigned Medicare billing, Maryland enrollment
  • 664 clinicians in this Medicare group
NPI 1669182499 (410) 601-9000

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 5

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.
96 services53 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.
42 services22 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
35 services35 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
25 services25 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.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06510 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

93.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.72
Promoting Interoperability78.03
Improvement Activities40

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.

AUDREY P SENIOR APRN
Nurse Practitioner (Family)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-5860
DR. YEISID F FIGUEREDO M.D.
Pediatrics (Neonatal-Perinatal Medicine)
20 YORK ST, DEPT OF NEONATOLOGY
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-2320
YALE NEW HAVEN HOSPITAL
Durable Medical Equipment & Medical Supplies (Customized Equipment)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-2046
TAYLOR KINGSTON
Dietitian, Registered
20 YORK ST, FOOD AND NUTRITION EPB806
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-9185
DR. TRAVIS DANIEL BONTRAGER MD
Hospitalist
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-1734
TERESA JOSEPH D.O.
Internal Medicine (Nephrology)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 737-8894
MR. BRAD ST. MARTIN MD
Obstetrics & Gynecology
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4242
BERNADETTE BIMONTE-HACKETT LCSW
Social Worker (Clinical)
20 YORK ST, SOCIAL WORK EP10-635
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 785-5161

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 Doran's NPI number?

The NPI number for James Doran is 1437682481. It was assigned to this individual provider in the NPPES registry on April 6, 2017.

Where is James Doran located?

James Doran practices at 20 York St Cb2041, New Haven, CT 06510. The listed phone number is (203) 688-4748.

What is James Doran's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Doran enrolled in Medicare?

Yes. James Doran 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 Doran's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Doran reassigns Medicare benefits to 2 organizations: Mill Hill Medical Consultants Inc (New Haven, CT) and Sinai Hospital Of Baltimore Inc (Towson, MD). 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 Doran's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Doran accept?

Health plans from Anthem Blue Cross and Blue Shield list James Doran 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.

When was this NPI record last updated?

The NPPES record for James Doran was last updated on August 10, 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.