DR. JAMES A KNUPP MD
NPI 1548211774
Ophthalmology in Toledo, OH

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment
97.05/100
CMS Quality Rating
1000 REGENCY CT STE 100, TOLEDO, OH 43623(419) 882-0588(419) 885-3070 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2025, Apr 3, 2023, Apr 13, 2021 (3 updates tracked since 2021).

About Dr. James A Knupp Md NPPES

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

DR. JAMES A KNUPP MD (NPI 1548211774) is an individual ophthalmology provider in Toledo, Ohio, licensed in Ohio (35042466) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bowling Green, and is a graduate of Ohio State University College Of Medicine (1978).

NPPES Registry Identity

NPI1548211774
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. JAMES A KNUPPCredential: MD
Location Address1000 REGENCY CT STE 100Toledo, OH 43623-3074
Mailing Address1000 Regency Ct, Suite 100Toledo, OH 43623-3091 · (419) 882-0588 · Fax (419) 885-3070
Fax(419) 885-3070
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 1978
Enumeration DateMay 12, 2006
Last NPPES UpdateNovember 19, 20253 updates tracked since enumeration
NPPES CertifiedNovember 19, 2025
NPI 1548211774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in OH · 35042466 Licensed in IL · 036075866
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1000 REGENCY CT STE 100, Toledo, OH 43623

Secondary Practice Location 1

Location 1960 W Wooster St Ste 216Bowling Green, OH 43402-2650 · Phone (419) 352-5500 · Fax (419) 352-5577

Other Identifiers 2

Medicaid0086973OH
Medicaid036075866IL

Accepted 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 A Knupp 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 ID446212633
PECOS Enrollment IDI20130628000504
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 11

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
156 services135 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
136 services119 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
130 services115 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.
121 services98 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
93 services64 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
60 services54 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43623 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
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.

97.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality94.1
Improvement Activities40

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination
100%129 patients5/55-star benchmark: 100%
Diabetes: Eye Exam
100%249 patients5/55-star benchmark: 100%
Glaucoma Intraocular Pressure Reduction
85%274 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
25%124 patients
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care
95%110 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 679 patients
Patients totalRate: 0% · 679 patients
0%679 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.

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.

Ophthalmology
1000 REGENCY CT STE 100
TOLEDO, OH 43623
Ophthalmology
1000 REGENCY CT STE 100
TOLEDO, OH 43623
Optometrist
1000 REGENCY CT STE 100
TOLEDO, OH 43623

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 Knupp's NPI number?

The NPI number for James Knupp is 1548211774. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is James Knupp located?

James Knupp practices at 1000 Regency Ct Ste 100, Toledo, OH 43623. The listed phone number is (419) 882-0588.

What is James Knupp's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is James Knupp enrolled in Medicare?

Yes. James Knupp 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 Knupp accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Louisiana and 9 other insurers list James Knupp 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 Knupp was last updated on November 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.