DR. JAMES PRAVEEN ANTHONY MD
NPI 1639356025
Internal Medicine - Pulmonary Disease in Valparaiso, IN

Q: What is James Anthony's NPI number?

The NPI number for James Anthony is 1639356025. It was assigned to this individual provider in the NPPES registry on January 28, 2008.

Q: What is James Anthony's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for James Anthony was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since January 28, 2008PECOS EnrolledAccepts Medicare Assignment

87.95/100

CMS Quality Rating

1101 GLENDALE BLVD, SUITE 103, VALPARAISO, IN 46383(219) 464-9054(219) 465-1749 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 28, 2026, Sep 10, 2020, Dec 27, 2017 and 1 more (4 updates tracked since 2016).

On this page

About Dr. James Praveen Anthony Md NPPES

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

DR. JAMES PRAVEEN ANTHONY MD (NPI 1639356025) is an individual pulmonary disease provider in Valparaiso, Indiana, licensed in Indiana (01071016A) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with Northwest Health-la Porte, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1639356025

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. JAMES PRAVEEN ANTHONYCredential: MD

Location Address1101 GLENDALE BLVD, SUITE 103Valparaiso, IN 46383-3767

Mailing Address1101 Glendale Blvd, Suite 103Valparaiso, IN 46383-3767 · (219) 464-9054 · Fax (219) 465-1749

Phone(219) 464-9054

Fax(219) 465-1749

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateJanuary 28, 2008

Last NPPES UpdateApril 28, 20264 updates tracked since enumeration

NPPES CertifiedApril 28, 2026

✔ NPI 1639356025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in IN · 01071016A✔ Licensed in IL · 036.125048

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 01071016A (IN), 036.125048 (IL)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 036.125048 (IL), 01071016A (IN)

1101 GLENDALE BLVD, Valparaiso, IN 46383

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 Praveen Anthony 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 ID1557555869

PECOS Enrollment IDI20120718000912

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 15

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

922 services203 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

596 services188 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.

271 services179 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.

152 services129 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

137 services119 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

93 services66 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

92 services91 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

92 services91 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

63 services62 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.

40 services40 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

37 services37 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

29 services29 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

23 services23 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

17 services17 patients

Insertion of artery tube for blood sampling or infusion through skin 36620

This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Northwest Health-La Porte

Acute Care Hospitals · La Porte, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150006

Location1331 State StreetLa Porte, IN 46350 · La Porte County

Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150034

Location1500 S Lake Park AveHobart, IN 46342 · Lake County

Emergency services Birthing friendly

Northwest Health - Porter

Acute Care Hospitals · Valparaiso, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150035

Location85 East Us Hwy 6Valparaiso, IN 46383 · Porter County

Emergency services Birthing friendly

Northwest Health - Starke

Acute Care Hospitals · Knox, IN

OwnershipProprietary

CMS Certification Number150102

Location102 E Culver RdKnox, IN 46534 · Starke County

Emergency services

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150126

Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46383 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

87.95/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.04

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

38%177 patients2/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

41%362 patients2/55-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

23%61 patients1/55-star benchmark: 100%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

75%61 patients4/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,010 patients5/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

66%356 patients3/55-star benchmark: 90%

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…

60%596 patients3/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 302 patients

Patients tobacco: 16% · 43 patients

84%302 patients4/55-star benchmark: 98%

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 23

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers32 claims32 services$36.72 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers11 claims20 services$1.17 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

7 suppliers38 claims38 services$92.17 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

8 suppliers44 claims107 services$33.73 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

4 suppliers16 claims78 services$17.35 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers26 claims26 services$52.66 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

7 suppliers38 claims38 services$18.23 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

7 suppliers37 claims37 services$13.86 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

7 suppliers67 claims321 services$2.14 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

4 suppliers14 claims14 services$12.24 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers42 claims42 services$15.48 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

4 suppliers105 claims105 services$774.99 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

3 suppliers13 claims13 services$80.74 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

5 suppliers20 claims22 services$4.55 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

4 suppliers54 claims54 services$35.58 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

12 suppliers344 claims347 services$75.99 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

8 suppliers225 claims225 services$31.44 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

13 suppliers37 claims12,554 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

14 suppliers44 claims6,870 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

4 suppliers13 claims1,290 services$0.80 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

3 suppliers42 claims46 services$31.76 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

19 suppliers71 claims71 services$22.23 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 90 days Q0514

DME-Other DME · category DE000N

10 suppliers13 claims13 services$51.90 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 14

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

DOUGLAS ADOLPH MAZUREK M.D.

Specialist

1101 GLENDALE BLVD, SUITE 103
VALPARAISO, IN 46383

Porter County (219) 464-9054

DR. MITCHELL J MAZUREK MD

Physical Medicine & Rehabilitation

1101 GLENDALE BLVD
VALPARAISO, IN 46383

Porter County (219) 464-2907

PORTER COUNTY PULMONARY AND CRITICAL CARE MEDICINE P.C.

Internal Medicine (Critical Care Medicine)

1101 GLENDALE BLVD, SUITE 102
VALPARAISO, IN 46383

Porter County (219) 464-9054

SUBBA RAO NAGUBADI MD

Urology

1101 GLENDALE BLVD, STE 111
VALPARAISO, IN 46383

Porter County (219) 464-1001

DYNAMIC REHABILITATION SERVICES PC

Physical Therapist

1101 GLENDALE BLVD, SUITE 11
VALPARAISO, IN 46383

Porter County (219) 476-0377

PORTER HEALTH SERVICES

Clinical Medical Laboratory

1101 GLENDALE BLVD
VALPARAISO, IN 46383

Porter County (216) 464-0232

DR. ELIZABETH KRISTINE CAMPBELL MD

Pediatrics

1101 GLENDALE BLVD, STE. 101
VALPARAISO, IN 46383

Porter County (219) 462-0555

AMBULATORY ANESTHESIA OF NORTHWEST INDIANA, LLC

Anesthesiology

1101 GLENDALE BLVD, SUITE 102
VALPARAISO, IN 46383

Porter County (219) 462-6144

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 Anthony's NPI number?

The NPI number for James Anthony is 1639356025. It was assigned to this individual provider in the NPPES registry on January 28, 2008.

Where is James Anthony located?

James Anthony practices at 1101 Glendale Blvd Suite 103, Valparaiso, IN 46383. The listed phone number is (219) 464-9054.

What is James Anthony's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is James Anthony enrolled in Medicare?

Yes. James Anthony 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 Anthony accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list James Anthony 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 Anthony affiliated with any hospitals?

According to CMS data, James Anthony is affiliated with Northwest Health-La Porte, St Mary Medical Center Inc, Northwest Health - Porter, Northwest Health - Starke and Franciscan Health Crown Point.

When was this NPI record last updated?

The NPPES record for James Anthony was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.