1. Home
  2. Directory
  3. Florida
  4. Sarasota
  5. Otolaryngology
  6. NPI Profile

DR. JAMES G HOULE M.D.
NPI 1619905957
Otolaryngology in Sarasota, FL

Active since June 28, 2006PECOS Enrolled
87.59/100
CMS Quality Rating
4937 CLARK RD STE 101, SARASOTA, FL 34233(941) 379-3277 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2025, May 22, 2023, Sep 23, 2022 and 3 more (6 updates tracked since 2022).

About Dr. James G Houle M.d. NPPES

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

DR. JAMES G HOULE M.D. (NPI 1619905957) is an individual otolaryngology provider in Sarasota, Florida, licensed in Florida (ME63917) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619905957
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. JAMES G HOULECredential: M.D.
Location Address4937 CLARK RD STE 101Sarasota, FL 34233-3241
Mailing Address4937 Clark Rd Ste 101Sarasota, FL 34233-3241 · (941) 379-3277 · Fax (941) 379-6277
Phone(941) 379-3277
Sole ProprietorYes
Enumeration DateJune 28, 2006
Last NPPES UpdateMay 28, 20256 updates tracked since enumeration
NPPES CertifiedMay 28, 2025
✔ NPI 1619905957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in FL · ME63917
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
4937 CLARK RD STE 101, Sarasota, FL 34233
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Wellpoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. James G Houle M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 10

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.
570 services270 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
201 services135 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
184 services136 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.
183 services183 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
174 services116 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
62 services52 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34233 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

87.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.34
Promoting Interoperability91
Improvement Activities40

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.

ABBIE HEUPEL PA
Physician Assistant
4937 CLARK RD STE 101
SARASOTA, FL 34233
Sarasota County (941) 379-3277
DR. ANDREW M MARLOWE M.D.
Otolaryngology (Otology & Neurotology)
4937 CLARK RD STE 101
SARASOTA, FL 34233
Sarasota County (941) 379-3277
ANDREW MARLOWE, MD, PA
Otolaryngology
4937 CLARK RD STE 101
SARASOTA, FL 34233
Sarasota County (941) 379-3277

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 Houle's NPI number?

The NPI number for James Houle is 1619905957. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is James Houle located?

James Houle practices at 4937 Clark Rd Ste 101, Sarasota, FL 34233. The listed phone number is (941) 379-3277.

What is James Houle's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James Houle enrolled in Medicare?

Yes. James Houle is registered in the Medicare PECOS enrollment system.

What insurance does James Houle accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Wellpoint list James Houle 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 Houle was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.