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DR. JAMES A GADE D.O.
NPI 1518286483
Family Medicine in Erie, PA

Active since May 18, 2010PECOS EnrolledAccepts Medicare Assignment
90.17/100
CMS Quality Rating
3535 PINE AVE, ERIE, PA 16504(814) 454-3363(814) 454-4945 Get Directions Write a Review

NPPES record last updated: November 26, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. James A Gade D.o. NPPES

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

DR. JAMES A GADE D.O. (NPI 1518286483) is an individual family medicine provider in Erie, Pennsylvania, licensed in Pennsylvania (OS014648) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS, is affiliated with Upmc Hamot, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2007).

NPPES Registry Identity

NPI1518286483
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES A GADECredential: D.O.
Location Address3535 PINE AVEErie, PA 16504-1743
Mailing Address3535 Pine AveErie, PA 16504-1743 · (814) 454-3363 · Fax (814) 454-4945
Phone(814) 454-3363
Fax(814) 454-4945
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2007
Enumeration DateMay 18, 2010
Last NPPES UpdateNovember 26, 2019
✔ NPI 1518286483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS014648
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.
3535 PINE AVE, Erie, PA 16504
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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 A Gade D.o. 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 ID1658495924
PECOS Enrollment IDI20100824000867
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 Gade reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Erie Physicians Network-Upmc,inc
2.5 mi
Family Medicine
1325 W 26TH ST
Erie, PA 16508
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 25 clinicians in this Medicare group
NPI 1366726259 (412) 647-0943
Epn Hamot Urgent Care LLC
4.4 mi
Family Medicine
7200 PEACH ST, UNIT 420
Erie, PA 16509
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 38 clinicians in this Medicare group
NPI 1518283753 (814) 860-3301

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.

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.
949 services180 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.
403 services109 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
183 services80 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.
182 services163 patients
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.
122 services71 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
110 services98 patients

Hospital Affiliations CMS Care Compare

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

Upmc Hamot

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390063
Location201 State StreetErie, PA 16550 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16504 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

90.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost64.22

Reported Quality Measures

Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%58 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 17

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

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
2 suppliers15 claims15 services$21.61 avg. paid by Medicare
Urinary catheter anchoring device, leg strap, each A4334
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$4.75 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers14 claims18 services$8.37 avg. paid by Medicare
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each A4389
DME-Orthotic Devices · category DF010N
2 suppliers13 claims140 services$6.00 avg. paid by Medicare
Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
2 suppliers20 claims1,936 services$0.10 avg. paid by Medicare
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. A5131
DME-Orthotic Devices · category DF000N
1 supplier12 claims12 services$14.01 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 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHILIP CACCHIONE
Family Medicine
3535 PINE AVE, 2ND FLOOR
ERIE, PA 16504
Erie County (814) 454-3363
KRISTAN CHILCOTT
Physician Assistant
3535 PINE AVE, SUITE 2
ERIE, PA 16504
Erie County (814) 454-3363
ERIE PHYSICIANS NETWORK, PC
Clinic/Center (Multi-Specialty)
3535 PINE AVE, 1ST FLOOR
ERIE, PA 16504
Erie County (814) 456-0893
JULIA NICHOLE EIMERS
Physical Therapy Assistant
3535 PINE AVE
ERIE, PA 16504
Erie County (814) 480-6845
DR. CRAIG TYRRELL JOHNSTON JR. DO
Family Medicine
3535 PINE AVE
ERIE, PA 16504
Erie County (814) 877-7260
ERIE PHYSICIANS NETWORK- UPMC INC
Non-Pharmacy Dispensing Site
3535 PINE AVE, STE 1
ERIE, PA 16504
Erie County (814) 454-3363
DR. CRAIG T JOHNSTON DO
Family Medicine
3535 PINE AVE, 1ST FLOOR
ERIE, PA 16504
Erie County (814) 454-3363
ERIE PHYSICIANS NETWORK PC
Clinic/Center (Multi-Specialty)
3535 PINE AVE, 1ST FLOOR
ERIE, PA 16504
Erie County (814) 456-5469

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 Gade's NPI number?

The NPI number for James Gade is 1518286483. It was assigned to this individual provider in the NPPES registry on May 18, 2010.

Where is James Gade located?

James Gade practices at 3535 Pine Ave, Erie, PA 16504. The listed phone number is (814) 454-3363.

What is James Gade's specialty?

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

Is James Gade enrolled in Medicare?

Yes. James Gade 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 Gade's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Gade reassigns Medicare benefits to 2 organizations: Erie Physicians Network-Upmc,inc (Erie, PA) and Epn Hamot Urgent Care LLC (Erie, PA). 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 Gade's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is James Gade affiliated with any hospitals?

According to CMS data, James Gade is affiliated with Upmc Hamot.

When was this NPI record last updated?

The NPPES record for James Gade was last updated on November 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.