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DR. JAMES Q. DONOVAN MD
NPI 1568413078
Family Medicine in Duluth, MN

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment
4190 LOBERG AVE, DULUTH, MN 55811(218) 249-4600(218) 249-4666 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 4, 2020, Feb 2, 2017 (2 updates tracked since 2017).

About Dr. James Q. Donovan Md NPPES

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

DR. JAMES Q. DONOVAN MD (NPI 1568413078) is an individual family medicine provider in Duluth, Minnesota, licensed in Minnesota (37964) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Lukes Hospital, and is a graduate of University Of Minnesota Medical School (1994).

NPPES Registry Identity

NPI1568413078
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JAMES Q. DONOVANCredential: MD
Location Address4190 LOBERG AVEDuluth, MN 55811-2652
Mailing Address4190 Loberg AveDuluth, MN 55811-2652 · (218) 249-4600 · Fax (218) 249-4666
Phone(218) 249-4600
Fax(218) 249-4666
Sole ProprietorNo
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1994
Enumeration DateMay 12, 2006
Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration
NPPES CertifiedDecember 4, 2020
✔ NPI 1568413078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 37964
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.
4190 LOBERG AVE, Duluth, MN 55811
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Other Identifiers 1

Medicaid666025800MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

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 Q. Donovan 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 ID6103967344
PECOS Enrollment IDI20100109000164
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 Donovan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Luke's Hospital Of Duluth
Same address
Family Medicine
4190 LOBERG AVE
Duluth, MN 55811
  • Reassigned Medicare billing, Minnesota enrollment
  • 513 clinicians in this Medicare group
NPI 1609828029 (218) 249-4600
Lake View Memorial Hospital, Inc
28 mi
Critical Access
325 11TH AVE
Two Harbors, MN 55616
  • Reassigned Medicare billing, Minnesota enrollment
  • 95 clinicians in this Medicare group
NPI 1023067642 (218) 834-7300

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 4

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.
128 services61 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.
72 services38 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
18 services18 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

St Lukes Hospital

Acute Care Hospitals · Duluth, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240047
Location915 East 1st StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55811 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

Other Providers at the Same Location NPPES 17

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

LAUREN WALLACE MD
Family Medicine
4190 LOBERG AVE
DULUTH, MN 55811
St. Louis County (218) 249-4600
NICOLE COLLISON DPT
Physical Therapist
4190 LOBERG AVE
HERMANTOWN, MN 55811
St. Louis County (218) 249-6040
DR. ELIZABETH A LILJEBLAD MD
Family Medicine
4190 LOBERG AVE
HERMANTOWN, MN 55811
St. Louis County (218) 249-4600
DR. GERARD DAVID SPOELHOF M.D.
Family Medicine
4190 LOBERG AVE
DULUTH, MN 55811
St. Louis County (218) 249-5700
BENJAMIN H JOHNSON MD
Family Medicine
4190 LOBERG AVE
DULUTH, MN 55811
St. Louis County (218) 249-5700
CHARLES EARL AHRENS M.D.
Ophthalmology
4190 LOBERG AVE
DULUTH, MN 55811
St. Louis County (218) 249-4600
MADELYN SODERBERG
Physical Therapist
4190 LOBERG AVE
HERMANTOWN, MN 55811
St. Louis County (218) 249-5700
MATTHEW GRANT PENNING M.D.
Family Medicine
4190 LOBERG AVE
DULUTH, MN 55811
St. Louis County (218) 249-5700

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 Donovan's NPI number?

The NPI number for James Donovan is 1568413078. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is James Donovan located?

James Donovan practices at 4190 Loberg Ave, Duluth, MN 55811. The listed phone number is (218) 249-4600.

What is James Donovan's specialty?

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

Is James Donovan enrolled in Medicare?

Yes. James Donovan 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 Donovan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Donovan reassigns Medicare benefits to 2 organizations: St. Luke's Hospital Of Duluth (Duluth, MN) and Lake View Memorial Hospital, Inc (Two Harbors, MN). 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 Donovan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Donovan accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and Security Health Plan list James Donovan 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 Donovan affiliated with any hospitals?

According to CMS data, James Donovan is affiliated with St Lukes Hospital.

When was this NPI record last updated?

The NPPES record for James Donovan was last updated on December 4, 2020. 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.