DR. JAMES H MARCUS M.D.
NPI 1568716629
Internal Medicine in New York, NY

Q: What is James Marcus's NPI number?

The NPI number for James Marcus is 1568716629. It was assigned to this individual provider in the NPPES registry on October 28, 2012.

Q: What is James Marcus's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for James Marcus was last updated on October 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since October 28, 2012PECOS EnrolledAccepts Medicare Assignment

638 COLUMBUS AVE, NEW YORK, NY 10024(212) 523-8672 Get Directions Write a Review

NPPES record last updated: October 16, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. James H Marcus M.d. NPPES

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

DR. JAMES H MARCUS M.D. (NPI 1568716629) is an individual internal medicine provider in New York, New York, licensed in New York (301021) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with St Joseph's Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1568716629

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. JAMES H MARCUSCredential: M.D.

Location Address638 COLUMBUS AVENew York, NY 10024-1406

Mailing Address1111 Amsterdam AveNew York, NY 10025-1716 · (212) 523-5918

Phone(212) 523-8672

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateOctober 28, 2012

Last NPPES UpdateOctober 16, 2019

✔ NPI 1568716629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in NY · 301021✔ Licensed in OH · 57.021861

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

638 COLUMBUS AVE, New York, NY 10024

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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 H Marcus M.d. 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 ID2365716990

PECOS Enrollment IDI20191028000844

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

Medicare enrollment records show James Marcus reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Icahn School Of Medicine At Mount Sinai

0.9 mi

Infectious Disease

1 GUSTAVE L LEVY PL
New York, NY 10029

Reassigned Medicare billing, New York enrollment
769 clinicians in this Medicare group

NPI 1659639524 (212) 987-3100

Lawrence Medical Associates, PC

13 mi

Emergency Medicine

55 PALMER AVENUE, DEPARTMENT OF EMERGENCY MEDICINE
Bronxville, NY 10708

Reassigned Medicare billing, New York enrollment
531 clinicians in this Medicare group

NPI 1497260806 (914) 787-1000

Newburgh Physician Services PC

33 mi

Physical Medicine & Rehabilitation

66 W GILBERT ST
Tinton Falls, NJ 07701

Reassigned Medicare billing, New York enrollment
52 clinicians in this Medicare group

NPI 1205268364 (732) 212-0051

Sound Physicians Of Massachusetts, Inc

120 mi

Internal Medicine

575 BEECH ST
Holyoke, MA 01040

Reassigned Medicare billing, Massachusetts enrollment
337 clinicians in this Medicare group

NPI 1184178386 (413) 534-2500

Sound Physicians Of Massachusetts II PC

175 mi

Internal Medicine

235 N PEARL ST
Brockton, MA 02301

Reassigned Medicare billing, Massachusetts enrollment
173 clinicians in this Medicare group

NPI 1306376397 (615) 377-5658

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 7

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.

232 services81 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.

173 services58 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

78 services30 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.

57 services52 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.

39 services36 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

36 services18 patients

Hospital Affiliations CMS Care Compare 2

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

St Joseph's Medical Center

Acute Care Hospitals · Yonkers, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330006

Location127 South BroadwayYonkers, NY 10701 · Westchester County

Emergency services

Montefiore Medical Center

Acute Care Hospitals · Bronx, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330059

Location111 East 210th StreetBronx, NY 10467 · Bronx County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10024 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

$150.24 typical visit price

range $65.69 – $198.19

Typical copayment $37.56 (range $16.42 – $49.54)

Most-billed visit code 99204

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

58%110 patients3/55-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 9

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

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Emergency Medicine