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DR. JAMES REGIS MADISON DO
NPI 1447231311
Internal Medicine - Nephrology in Tahlequah, OK

Active since November 08, 2005PECOS EnrolledAccepts Medicare Assignment
1500 E DOWNING #102, TAHLEQUAH, OK 74464(918) 207-1189(918) 207-1160 Get Directions Write a Review

NPPES record last updated: May 13, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. James Regis Madison Do NPPES

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

DR. JAMES REGIS MADISON DO (NPI 1447231311) is an individual nephrology provider in Tahlequah, Oklahoma, licensed in Oklahoma (4485) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with North Hawaii Community Hospital, Inc, and is a graduate of Kansas City University Of Physicians And Surgeons (2001).

NPPES Registry Identity

NPI1447231311
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. JAMES REGIS MADISONCredential: DO
Location Address1500 E DOWNING #102Tahlequah, OK 74464
Mailing AddressPo Box 1008Tahlequah, OK 74465-1008 · (918) 207-1189 · Fax (918) 207-1160
Phone(918) 207-1189
Fax(918) 207-1160
Sole ProprietorNo
Medical School CMSKansas City University Of Physicians And SurgeonsGraduated 2001
Enumeration DateNovember 8, 2005
Last NPPES UpdateMay 13, 2010
✔ NPI 1447231311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in OK · 4485
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1500 E DOWNING #102, Tahlequah, OK 74464
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Other Identifiers 4

Medicaid200114250AOK
Medicare UPINI05995OK
Medicare PIN243727506OK
Medicare PINOK403699OK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.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 Regis Madison Do 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 ID3779568597
PECOS Enrollment IDI20061025000584
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 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.
374 services123 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
137 services121 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.
39 services37 patients
Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes 99235
This service involves a brief hospital stay for a moderate health issue. You'll be admitted and discharged on the same day, typically within 50 minutes. It's a quick, efficient way to receive necessary care and medical attention.
26 services26 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.
12 services11 patients

Hospital Affiliations CMS Care Compare

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

North Hawaii Community Hospital, Inc

Acute Care Hospitals · Kamuela, HI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number120028
Location67 1125 Mamalahoa HighwayKamuela, HI 96743 · Hawaii County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74464 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%198 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 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier13 claims13 services$19.79 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
3 suppliers37 claims37 services$102.74 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier13 claims13 services$37.94 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 James Madison's NPI number?

The NPI number for James Madison is 1447231311. It was assigned to this individual provider in the NPPES registry on November 8, 2005.

Where is James Madison located?

James Madison practices at 1500 E Downing #102, Tahlequah, OK 74464. The listed phone number is (918) 207-1189.

What is James Madison's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is James Madison enrolled in Medicare?

Yes. James Madison 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 Madison accept?

Health plans from HMSA list James Madison 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 Madison affiliated with any hospitals?

According to CMS data, James Madison is affiliated with North Hawaii Community Hospital, Inc.

When was this NPI record last updated?

The NPPES record for James Madison was last updated on May 13, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.