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JAMES MATTHEWS
NPI 1629697867
Family Medicine in Westlake, OH

Active since April 08, 2020PECOS Enrolled
960 CLAGUE RD STE 1100B, WESTLAKE, OH 44145(440) 397-4300 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About James Matthews NPPES

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

JAMES MATTHEWS (NPI 1629697867) is an individual family medicine provider in Westlake, Ohio, licensed in Ohio (35.144653) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Middleburg Heights, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1629697867
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES MATTHEWS
Location Address960 CLAGUE RD STE 1100BWestlake, OH 44145-1590
Mailing Address13390 W Sprague RdMiddleburg Heights, OH 44130-7140 · (440) 539-1224
Phone(440) 397-4300
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateApril 8, 2020
Last NPPES UpdateAugust 1, 2023
NPPES CertifiedMay 3, 2023
✔ NPI 1629697867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35.144653
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
960 CLAGUE RD STE 1100B, Westlake, OH 44145
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Secondary Practice Location 1

Location 17800 Pearl RdMiddleburg Heights, OH 44130-6552 · Phone (216) 957-9700

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Matthews is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496170201
PECOS Enrollment IDI20230410000697
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

2

Medicare enrollment records show James Matthews reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Metrohealth System
9.6 mi
Multi-Specialty
2500 METROHEALTH DR
Cleveland, OH 44109
  • Reassigned Medicare billing, Ohio enrollment
  • 2,147 clinicians in this Medicare group
NPI 1053353896 (216) 957-2442
Wedgewood Urgent Care, Ltd
111 mi
Family Medicine
10330 SAWMILL PKWY, SUITE 300
Powell, OH 43065
  • Reassigned Medicare billing, Ohio enrollment
  • 35 clinicians in this Medicare group
NPI 1487601167 (614) 923-9200

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 8

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
109 services109 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.
52 services52 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.
51 services51 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
50 services24 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
31 services31 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.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44145 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Other Providers at the Same Location NPPES 4

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

UNIVERSITY HOSPITALS MEDICAL PRACTICES INC
Clinic/Center (Urgent Care)
960 CLAGUE RD STE 1100B
WESTLAKE, OH 44145
Cuyahoga County (440) 250-5366
UNIVERSITY PRIMARY CARE PRACTICES INC
Clinic/Center (Urgent Care)
960 CLAGUE RD STE 1100B
WESTLAKE, OH 44145
Cuyahoga County (440) 250-5366
UNIVERSITY HOSPITALS URGENT CARE, LLC
Clinic/Center (Urgent Care)
960 CLAGUE RD STE 1100B
WESTLAKE, OH 44145
Cuyahoga County (440) 250-5366
DR. RANDY PETER PLONA MD
Family Medicine
960 CLAGUE RD STE 1100B
WESTLAKE, OH 44145
Cuyahoga County (216) 383-0100

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 Matthews's NPI number?

The NPI number for James Matthews is 1629697867. It was assigned to this individual provider in the NPPES registry on April 8, 2020.

Where is James Matthews located?

James Matthews practices at 960 Clague Rd Ste 1100B, Westlake, OH 44145. The listed phone number is (440) 397-4300.

What is James Matthews's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is James Matthews enrolled in Medicare?

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

Which organizations bill Medicare for James Matthews's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Matthews reassigns Medicare benefits to 2 organizations: The Metrohealth System (Cleveland, OH) and Wedgewood Urgent Care, Ltd (Powell, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Matthews's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Matthews accept?

Health plans from Blue Cross Blue Shield of Arizona, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance list James Matthews 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 Matthews was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.