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JAMES ARTHUR MACDONALD M.D.
NPI 1639164296
Pathology - Anatomic Pathology & Clinical Pathology in Tifton, GA

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment
78.41/100
CMS Quality Rating
901 18TH ST E, TIFTON, GA 31794(229) 353-7535 Get Directions Write a Review

NPPES record last updated: June 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About James Arthur Macdonald M.d. NPPES

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

JAMES ARTHUR MACDONALD M.D. (NPI 1639164296) is an individual anatomic pathology & clinical pathology provider in Tifton, Georgia, licensed in Georgia (035467) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Dorminy Medical Center, and is a graduate of George Washington University School Of Medicine (1982).

NPPES Registry Identity

NPI1639164296
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameJAMES ARTHUR MACDONALDCredential: M.D.
Location Address901 18TH ST ETifton, GA 31794
Mailing Address907 18th St E Ste 150Tifton, GA 31794-3690 · (229) 353-7535
Phone(229) 353-7535
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 1982
Enumeration DateSeptember 20, 2005
Last NPPES UpdateJune 28, 2018
✔ NPI 1639164296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in GA · 035467
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Also ListedSpecialistTaxonomy 174400000X · License 035467 (GA)
901 18TH ST E, Tifton, GA 31794
Open in Google Maps ↗

Other Identifiers 1

Medicaid000495602AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Arthur Macdonald 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 ID6608068069
PECOS Enrollment IDI20101005000089
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

3

Medicare enrollment records show James Macdonald reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tift Regional Health System Inc
Same address
Clinic/Center
907 18TH ST E, SUITE 140
Tifton, GA 31794
  • Reassigned Medicare billing, Georgia enrollment
  • 380 clinicians in this Medicare group
NPI 1306244090 (229) 353-4325
Tift Regional Health System Inc
Same address
Clinic/Center
907 18TH ST E, SUITE 140
Tifton, GA 31794
  • Reassigned Medicare billing, Georgia enrollment
  • 337 clinicians in this Medicare group
NPI 1306244090 (229) 353-4325
Tifton Pathological Services
0.1 mi
Clinical Medical Laboratory
907 18TH ST E
Tifton, GA 31794
  • Reassigned Medicare billing, Georgia enrollment
  • 2 clinicians in this Medicare group
NPI 1225098551 (229) 353-7535

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 4

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
242 services115 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
65 services55 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
45 services13 patients
Pathology examination of tissue using a microscope, moderately low complexity 88304
A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
14 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Dorminy Medical Center

Acute Care Hospitals · Fitzgerald, GA
OwnershipGovernment - Local
CMS Certification Number110073
Location200 Perry House Road, Box 1447Fitzgerald, GA 31750 · Ben Hill County
Emergency services

Tift Regional Medical Center

Acute Care Hospitals · Tifton, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110095
Location901 E 18th StreetTifton, GA 31793 · Tift County
Emergency services Birthing friendly

Cook Medical Center A Campus Of Tift Reg Med Ctr

Acute Care Hospitals · Adel, GA
OwnershipProprietary
CMS Certification Number110101
Location260 Mj Taylor RoadAdel, GA 31620 · Cook County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31794 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

78.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.68
Promoting Interoperability100
Improvement Activities40
Cost66.15

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.

COLE BURGESS CRNA
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
ISRAEL SAUCEDO APRN, FNP-C
Nurse Practitioner (Acute Care)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-7050
JAVERIA NASEER MBBS
Student in an Organized Health Care Education/Training Program
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120
WILLIAM A GUEST MD
Internal Medicine (Pulmonary Disease)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3400
JOSE ABANTAO PT
Physical Therapist
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3347
DR. KAMRAN LATEEF MD
Internal Medicine
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6051
HEATH FARMER CRNA
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
DAVID RYAN ATKINS APRN-BC
Nurse Practitioner (Family)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120

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 Macdonald's NPI number?

The NPI number for James Macdonald is 1639164296. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is James Macdonald located?

James Macdonald practices at 901 18th St E, Tifton, GA 31794. The listed phone number is (229) 353-7535.

What is James Macdonald's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is James Macdonald enrolled in Medicare?

Yes. James Macdonald 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.

Which organizations bill Medicare for James Macdonald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Macdonald reassigns Medicare benefits to 3 organizations: Tift Regional Health System Inc (Tifton, GA), Tift Regional Health System Inc (Tifton, GA) and Tifton Pathological Services (Tifton, GA). 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 Macdonald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Macdonald accept?

Health plans from Alliant Health Plans, Inc. list James Macdonald 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 Macdonald affiliated with any hospitals?

According to CMS data, James Macdonald is affiliated with Dorminy Medical Center, Tift Regional Medical Center and Cook Medical Center A Campus Of Tift Reg Med Ctr.

When was this NPI record last updated?

The NPPES record for James Macdonald was last updated on June 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.