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DR. JAMES LAWRENCE EPPELBAUM D.O.
NPI 1558609065
Family Medicine in Saegertown, PA

Active since January 18, 2013PECOS EnrolledAccepts Medicare Assignment
401 MAIN ST, SAEGERTOWN, PA 16433(147) 631-1068(814) 763-1129 Get Directions Write a Review

NPPES record last updated: June 10, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. James Lawrence Eppelbaum D.o. NPPES

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

DR. JAMES LAWRENCE EPPELBAUM D.O. (NPI 1558609065) is an individual family medicine provider in Saegertown, Pennsylvania, licensed in Pennsylvania (OS017230) and active in the NPI registry since January 2013. He is enrolled in Medicare PECOS, is affiliated with Upmc Hamot, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1558609065
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES LAWRENCE EPPELBAUMCredential: D.O.
Location Address401 MAIN STSaegertown, PA 16433-0846
Mailing Address1034 Grove StMeadville, PA 16335-2945 · (814) 373-3530 · Fax (814) 333-1757
Phone(147) 631-1068
Fax(814) 763-1129
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJanuary 18, 2013
Last NPPES UpdateJune 10, 2021
NPPES CertifiedMay 24, 2021
✔ NPI 1558609065 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 · OS017230
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.
401 MAIN ST, Saegertown, PA 16433
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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 Lawrence Eppelbaum 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 ID6305088634
PECOS Enrollment IDI20141013000663
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 Eppelbaum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Doctors Of Emergency Medicine Of Illinois III, LLC
5.4 mi
Hospitalist
751 LIBERTY ST
Meadville, PA 16335
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 32 clinicians in this Medicare group
NPI 1245081322 (814) 373-2310
Hospitalist Medicine Physicians Of Pennsylvania, P.C.
131 mi
Internal Medicine
225 S CENTER AVE
Somerset, PA 15501
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Hospitalist Medicine Physicians Of Pennsylvania PC
  • 274 clinicians in this Medicare group
NPI 1639464308 (814) 443-5000

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 6

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.
336 services166 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.
131 services126 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.
114 services74 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.
102 services99 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.
82 services76 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.
80 services79 patients

Hospital Affiliations CMS Care Compare 3

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

Meadville Medical Center

Acute Care Hospitals · Meadville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390113
Location751 Liberty StreetMeadville, PA 16335 · Crawford County
Emergency services Birthing friendly

Titusville Area Hospital

Critical Access Hospitals · Titusville, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391314
Location406 West Oak StreetTitusville, PA 16354 · Crawford County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16433 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.

Referred Medical Equipment & Supplies CMS DME claims

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

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 suppliers24 claims25 services$110.18 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 2

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

JOSEPH WILLIAM MERCURIO D.O.
Family Medicine
401 MAIN ST
SAEGERTOWN, PA 16433
Crawford County (814) 763-1106
TITUSVILLE AREA HOSPITAL
Clinic/Center (Rural Health)
401 MAIN ST
SAEGERTOWN, PA 16433
Crawford County (814) 763-1106

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 Eppelbaum's NPI number?

The NPI number for James Eppelbaum is 1558609065. It was assigned to this individual provider in the NPPES registry on January 18, 2013.

Where is James Eppelbaum located?

James Eppelbaum practices at 401 Main St, Saegertown, PA 16433. The listed phone number is (147) 631-1068.

What is James Eppelbaum's specialty?

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

Is James Eppelbaum enrolled in Medicare?

Yes. James Eppelbaum 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 Eppelbaum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Eppelbaum reassigns Medicare benefits to 2 organizations: Doctors Of Emergency Medicine Of Illinois III, LLC (Meadville, PA) and Hospitalist Medicine Physicians Of Pennsylvania, P.C. (Somerset, 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 Eppelbaum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is James Eppelbaum affiliated with any hospitals?

According to CMS data, James Eppelbaum is affiliated with Upmc Hamot, Meadville Medical Center and Titusville Area Hospital.

When was this NPI record last updated?

The NPPES record for James Eppelbaum was last updated on June 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.