JAMES P SUTHERLAND JR. MD
NPI 1619965589
Orthopaedic Surgery in Wausau, WI

Active since October 13, 2005PECOS EnrolledAccepts Medicare Assignment
85.24/100
CMS Quality Rating
3901 STEWART AVE, WAUSAU, WI 54401(715) 907-0900(715) 803-6977 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 12, 2022, Aug 26, 2022, Mar 10, 2022 and 1 more (4 updates tracked since 2022).

About James P Sutherland Jr. Md NPPES

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

JAMES P SUTHERLAND JR. MD (NPI 1619965589) is an individual orthopaedic surgery provider in Wausau, Wisconsin, licensed in Wisconsin (40384) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Aspirus Rhinelander Hospital, and is a graduate of University Of Louisville School Of Medicine (1989).

NPPES Registry Identity

NPI1619965589
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameJAMES P SUTHERLAND JR.Credential: MD
Location Address3901 STEWART AVEWausau, WI 54401-3948
Mailing Address3901 Stewart AveWausau, WI 54401-3948 · (715) 907-0900 · Fax (715) 803-6977
Fax(715) 803-6977
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1989
Enumeration DateOctober 13, 2005
Last NPPES UpdateFebruary 23, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2026
NPI 1619965589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in WI · 40384
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
3901 STEWART AVE, Wausau, WI 54401

Other Identifiers 1

Medicaid32464800WI

Accepted 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

James P Sutherland 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 ID3971578543
PECOS Enrollment IDI20050110000855
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 14

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 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.
160 services130 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
140 services93 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
105 services69 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
57 services35 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
54 services35 patients
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.
35 services34 patients

Hospital Affiliations CMS Care Compare 3

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

Aspirus Rhinelander Hospital

Acute Care Hospitals · Rhinelander, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520019
Location2251 North Shore DrRhinelander, WI 54501 · Oneida County
Emergency services Birthing friendly

Aspirus Wausau Hospital

Acute Care Hospitals · Wausau, WI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number520030
Location333 Pine Ridge BlvdWausau, WI 54401 · Marathon County
Emergency services Birthing friendly

Langlade Hospital

Critical Access Hospitals · Antigo, WI
OwnershipVoluntary non-profit - Church
CMS Certification Number521350
Location112 E Fifth AveAntigo, WI 54409 · Langlade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54401 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

85.24/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality55.49
Promoting Interoperability96
Improvement Activities40
Cost98.65

Reported Quality Measures

Advance Care Plan
82%567 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
99%1,301 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
57%550 patients3/55-star benchmark: 100%
Functional Status Assessment for Total Hip Replacement
10%63 patients
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 87% · 546 patients
Patients screened: 89% · 546 patients
75%44 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
65%373 patients3/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 579 patients
Patients totalRate: 1% · 579 patients
0%579 patients5/55-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 20

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

Orthopaedic Surgery (Hand Surgery)
3901 STEWART AVE
WAUSAU, WI 54401
Orthopaedic Surgery
3901 STEWART AVE
WAUSAU, WI 54401
Orthopaedic Surgery (Foot and Ankle Surgery)
3901 STEWART AVE
WAUSAU, WI 54401
Orthopaedic Surgery (Hand Surgery)
3901 STEWART AVE
WAUSAU, WI 54401
Physician Assistant (Medical)
3901 STEWART AVE
WAUSAU, WI 54401
Physical Therapist
3901 STEWART AVE
WAUSAU, WI 54401
Occupational Therapist
3901 STEWART AVE
WAUSAU, WI 54401
Physician Assistant
3901 STEWART AVE
WAUSAU, WI 54401

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 Sutherland's NPI number?

The NPI number for James Sutherland is 1619965589. It was assigned to this individual provider in the NPPES registry on October 13, 2005.

Where is James Sutherland located?

James Sutherland practices at 3901 Stewart Ave, Wausau, WI 54401. The listed phone number is (715) 907-0900.

What is James Sutherland's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is James Sutherland enrolled in Medicare?

Yes. James Sutherland 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 Sutherland accept?

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

According to CMS data, James Sutherland is affiliated with Aspirus Rhinelander Hospital, Aspirus Wausau Hospital and Langlade Hospital.

When was this NPI record last updated?

The NPPES record for James Sutherland was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.