1. Home
  2. Directory
  3. Tennessee
  4. Knoxville
  5. Internal Medicine
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PRASHANT J JAMES M.D.
NPI 1609250562
Internal Medicine - Sleep Medicine in Knoxville, TN

Active since July 10, 2015PECOS Enrolled
95.69/100
CMS Quality Rating
1346 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909(865) 234-4311(865) 351-0035 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 24, 2026, Sep 30, 2022, Aug 21, 2019 and 1 more (4 updates tracked since 2016).

About Prashant J James M.d. NPPES

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

PRASHANT J JAMES M.D. (NPI 1609250562) is an individual sleep medicine provider in Knoxville, Tennessee, licensed in Tennessee (66304) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1609250562
Entity TypeIndividualMale
Primary Taxonomy207RS0012X
Provider Legal NamePRASHANT J JAMESCredential: M.D.
Location Address1346 DOWELL SPRINGS BLVDKnoxville, TN 37909
Mailing Address11409 Municipal Center Drive #22667Knoxville, TN 37922 · (865) 234-4311 · Fax (865) 351-0035
Phone(865) 234-4311
Fax(865) 351-0035
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 10, 2015
Last NPPES UpdateJuly 24, 20264 updates tracked since enumeration
NPPES CertifiedJuly 24, 2026
✔ NPI 1609250562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License✔ Licensed in TN · 66304
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
1346 DOWELL SPRINGS BLVD, Knoxville, TN 37909
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.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

Prashant J James 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 ID9931493434
PECOS Enrollment IDI20220831000267
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 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.

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.
254 services127 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
57 services51 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
53 services51 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
52 services52 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.
39 services35 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.
23 services20 patients

Hospital Affiliations CMS Care Compare

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

University Health System, Inc

Acute Care Hospitals · Knoxville, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440015
Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37909 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

95.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.28
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 18

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
23 suppliers380 claims380 services$30.33 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
19 suppliers206 claims206 services$67.98 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
19 suppliers213 claims496 services$26.13 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
16 suppliers233 claims1,091 services$14.27 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
10 suppliers81 claims394 services$11.89 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
18 suppliers289 claims289 services$45.62 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.

SANGEETHA KODOTH MD
Allergy & Immunology
1346 DOWELL SPRINGS BLVD
KNOXVILLE, TN 37909
Knox County (865) 588-2753
ALLERGY SPECIALISTS OF KNOXVILLE PLLC
Allergy & Immunology
1346 DOWELL SPRINGS BLVD
KNOXVILLE, TN 37909
Knox County (865) 588-2753
DREAM CARE TN PLLC
Clinic/Center (Sleep Disorder Diagnostic)
1346 DOWELL SPRINGS BLVD
KNOXVILLE, TN 37909
Knox County (865) 816-9393

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 Prashant James's NPI number?

The NPI number for Prashant James is 1609250562. It was assigned to this individual provider in the NPPES registry on July 10, 2015.

Where is Prashant James located?

Prashant James practices at 1346 Dowell Springs Blvd, Knoxville, TN 37909. The listed phone number is (865) 234-4311.

What is Prashant James's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Prashant James enrolled in Medicare?

Yes. Prashant James 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 Prashant James accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Prashant James 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 Prashant James affiliated with any hospitals?

According to CMS data, Prashant James is affiliated with University Health System, Inc.

When was this NPI record last updated?

The NPPES record for Prashant James was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.