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DR. JAMES MATTHEW GARDNER MD
NPI 1528039054
Family Medicine - Addiction Medicine in Richmond, VA

Active since February 01, 2006PECOS EnrolledAccepts Medicare Assignment
33.26/100
CMS Quality Rating
1510 N 28TH ST STE 101, RICHMOND, VA 23223(804) 521-0050(833) 973-3890 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. James Matthew Gardner Md NPPES

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

DR. JAMES MATTHEW GARDNER MD (NPI 1528039054) is an individual addiction medicine provider in Richmond, Virginia, licensed in Virginia (0101049730) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Virginia Commonwealth University, School Of Medicine (1992).

NPPES Registry Identity

NPI1528039054
Entity TypeIndividualMale
Primary Taxonomy207QA0401X
Provider Legal NameDR. JAMES MATTHEW GARDNERCredential: MD
Location Address1510 N 28TH ST STE 101Richmond, VA 23223-5311
Mailing Address1510 N 28th St Ste 101Richmond, VA 23223-5311 · (804) 521-0050 · Fax (833) 973-3890
Phone(804) 521-0050
Fax(833) 973-3890
Sole ProprietorNo
Medical School CMSVirginia Commonwealth University, School Of MedicineGraduated 1992
Enumeration DateFebruary 1, 2006
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1528039054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in VA · 0101049730
Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.

1510 N 28TH ST STE 101, Richmond, VA 23223
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Other Identifiers 1

Medicaid1528039054VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.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 Matthew Gardner 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 ID6507888435
PECOS Enrollment IDI20051220000715
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 2

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 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.
172 services51 patients
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.
70 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23223 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

33.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality8.51
Promoting Interoperability0
Improvement Activities20
Cost60.71

Referred Medical Equipment & Supplies CMS DME claims 2

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

Stationary oxygen contents, liquid, 1 month's supply = 1 unit E0442
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$45.16 avg. paid by Medicare
Portable oxygen contents, liquid, 1 month's supply = 1 unit E0444
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$42.24 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 3

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

CHRISTA MARIE ADAMS LPC
Counselor (Professional)
1510 N 28TH ST STE 101
RICHMOND, VA 23223
Henrico County (804) 521-0050
TERESA ANNETTE TURNER- STREET
Counselor (Addiction (Substance Use Disorder))
1510 N 28TH ST STE 101
RICHMOND, VA 23223
Henrico County (804) 521-0050
PATRICK ANTONINO PAGANO CSAC
Counselor (Addiction (Substance Use Disorder))
1510 N 28TH ST STE 101
RICHMOND, VA 23223
Henrico County (804) 521-0050

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 Gardner's NPI number?

The NPI number for James Gardner is 1528039054. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Where is James Gardner located?

James Gardner practices at 1510 N 28th St Ste 101, Richmond, VA 23223. The listed phone number is (804) 521-0050.

What is James Gardner's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Is James Gardner enrolled in Medicare?

Yes. James Gardner 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 Gardner accept?

Health plans from BlueCross BlueShield of Tennessee list James Gardner 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 Gardner was last updated on April 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.