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DR. JAMES E. SPELLMAN JR. MD
NPI 1609864982
Surgery - Surgical Oncology in Rehoboth Beach, DE

Active since October 11, 2005PECOS EnrolledAccepts Medicare Assignment
18947 JOHN J WILLIAMS HWY, SUITE 205, REHOBOTH BEACH, DE 19971(302) 644-0964(302) 644-0968 Get Directions Write a Review

NPPES record last updated: February 5, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James E. Spellman Jr. Md NPPES

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

DR. JAMES E. SPELLMAN JR. MD (NPI 1609864982) is an individual surgical oncology provider in Rehoboth Beach, Delaware, licensed in Delaware (C10004807) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1984).

NPPES Registry Identity

NPI1609864982
Entity TypeIndividualMale
Primary Taxonomy2086X0206X
Provider Legal NameDR. JAMES E. SPELLMAN JR.Credential: MD
Location Address18947 JOHN J WILLIAMS HWY, SUITE 205Rehoboth Beach, DE 19971-4474
Mailing Address400 Savannah Rd, Suite BLewes, DE 19958-1499 · (302) 645-6555 · Fax (302) 644-3560
Phone(302) 644-0964
Fax(302) 644-0968
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1984
Enumeration DateOctober 11, 2005
Last NPPES UpdateFebruary 5, 2014
✔ NPI 1609864982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Surgical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2086X0206X
License✔ Licensed in DE · C10004807
Definition
A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research.
18947 JOHN J WILLIAMS HWY, Rehoboth Beach, DE 19971
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Other Identifiers 10

Medicare PIN020689B86DE
Other000000207585DE · Unison Health Care-mcaid
Other563293DE · Coventry Health Care
OtherP00397509DE · Railroad Medicare
Other1609864982DE · Diamond State Medicaid
Other1609864982DE · De Physician Care-mcaid
Other522011SURDE · Bcbs Of Delaware-surgical
Medicare UPINF66193
Medicare ID-Type Unspecified490906DE
Medicaid1609864982DE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.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 E. Spellman Jr. 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 ID3476656513
PECOS Enrollment IDI20070312000107
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 straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
131 services112 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.
99 services73 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.
26 services26 patients
Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm 11601
This procedure involves the surgical removal of a cancerous skin growth that measures between 0.6-1.0 cm, found on the body, arms, or legs. The goal is to eliminate cancer cells to prevent further spread. It's a common, safe, and effective treatment.
24 services24 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
18 services18 patients
Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602
This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.
15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19971 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
$173.08 typical visit price
range $57.12 – $173.08
Typical copayment $43.27 (range $14.28 – $43.27)
Most-billed visit code 99205
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
52%401 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
17%24 patients1/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
22%429 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%414 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
40%760 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
29%735 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
93%760 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
22%760 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
33%760 patients
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
3 suppliers20 claims395 services$5.39 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
2 suppliers12 claims320 services$3.25 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 20

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

CATHERINE M HAUT CPNP
Nurse Practitioner (Pediatrics, Critical Care)
18947 JOHN J WILLIAMS HWY, SUITE 212
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-8212
MS. AUDREY UMSCHLAG RN
Registered Nurse
18947 JOHN J WILLIAMS HWY
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-3770
KATHRYN A MANGION NP
Nurse Practitioner (Adult Health)
18947 JOHN J WILLIAMS HWY, SUITE 210
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-3121
DR. JUDITH B GORRA MD
Pediatrics
18947 JOHN J WILLIAMS HWY, SUITE 212
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-8212
ARLENE C FELECCIA RD, CDE, LDN
Dietitian, Registered
18947 JOHN J WILLIAMS HWY, SUITE 210
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-3121
RHONDA KAY OWENS APRN
Nurse Practitioner
18947 JOHN J WILLIAMS HWY
REHOBOTH BEACH, DE 19971
Sussex County (302) 645-3770
DELAWARE SLEEP DISORDER CENTERS, LLC
Clinic/Center (Sleep Disorder Diagnostic)
18947 JOHN J WILLIAMS HWY, SUITE 213
REHOBOTH BEACH, DE 19971
Sussex County (877) 335-7533
BAYSHORE HEALTH & WELLNESS
Clinic/Center (Medical Specialty)
18947 JOHN J WILLIAMS HWY, SUITE 306
REHOBOTH BEACH, DE 19971
Sussex County (302) 703-2146

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 Spellman's NPI number?

The NPI number for James Spellman is 1609864982. It was assigned to this individual provider in the NPPES registry on October 11, 2005.

Where is James Spellman located?

James Spellman practices at 18947 John J Williams Hwy Suite 205, Rehoboth Beach, DE 19971. The listed phone number is (302) 644-0964.

What is James Spellman's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Oncology, with taxonomy code 2086X0206X.

Is James Spellman enrolled in Medicare?

Yes. James Spellman 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 Spellman accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list James Spellman 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 Spellman was last updated on February 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.