JAMES M BANOVETZ MD, PHD
NPI 1649348749
Orthopaedic Surgery in Stevens Point, WI

Active since November 30, 2006PECOS EnrolledAccepts Medicare Assignment
82.16/100
CMS Quality Rating
500 VINCENT ST, STEVENS POINT, WI 54481(715) 344-0701(715) 344-4494 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 11, 2022, May 1, 2019 (2 updates tracked since 2019).

About James M Banovetz Md, Phd NPPES

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

JAMES M BANOVETZ MD, PHD (NPI 1649348749) is an individual orthopaedic surgery provider in Stevens Point, Wisconsin, licensed in Wisconsin (37860) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Aspirus Stevens Point Hospital & Clinics, Inc., and is a graduate of Northwestern University Feinberg Medical School (1990).

NPPES Registry Identity

NPI1649348749
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameJAMES M BANOVETZCredential: MD, PHD
Location Address500 VINCENT STStevens Point, WI 54481-1842
Mailing Address500 Vincent StStevens Point, WI 54481-1842 · (715) 344-0701 · Fax (715) 344-4494
Fax(715) 344-4494
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1990
Enumeration DateNovember 30, 2006
Last NPPES UpdateMay 11, 20222 updates tracked since enumeration
NPPES CertifiedMay 11, 2022
NPI 1649348749 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 · 37860
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.

500 VINCENT ST, Stevens Point, WI 54481

Other Identifiers 1

Medicaid32256800WI

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 M Banovetz Md, Phd 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 ID8325098973
PECOS Enrollment IDI20050201000016
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 12

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.
49 services39 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.
47 services32 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.
31 services29 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
27 services24 patients
Mri scan of arm joint without contrast 73221
An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.
17 services16 patients
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.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Aspirus Stevens Point Hospital & Clinics, Inc.

Acute Care Hospitals · Stevens Point, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520002
Location900 Illinois AveStevens Point, WI 54481 · Portage 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54481 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.

82.16/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality65.6
Promoting Interoperability93
Improvement Activities40
Cost80.77

Reported Quality Measures

Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
44%101 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%169 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
36%516 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
35%516 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
3%516 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
25%516 patients
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.

Anesthesiology
500 VINCENT ST
STEVENS POINT, WI 54481
Anesthesiology
500 VINCENT ST
STEVENS POINT, WI 54481
Anesthesiology
500 VINCENT ST
STEVENS POINT, WI 54481
Anesthesiology
500 VINCENT ST
STEVENS POINT, WI 54481
Anesthesiology
500 VINCENT ST
STEVENS POINT, WI 54481
Psychiatry & Neurology (Neurology)
500 VINCENT ST
STEVENS POINT, WI 54481
Orthopaedic Surgery
500 VINCENT ST
STEVENS POINT, WI 54481
Urology
500 VINCENT ST, SUITE D
STEVENS POINT, WI 54481

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 Banovetz's NPI number?

The NPI number for James Banovetz is 1649348749. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Where is James Banovetz located?

James Banovetz practices at 500 Vincent St, Stevens Point, WI 54481. The listed phone number is (715) 344-0701.

What is James Banovetz's specialty?

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

Is James Banovetz enrolled in Medicare?

Yes. James Banovetz 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 Banovetz accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners, Medica and Sanford Health Plan and 1 other insurer list James Banovetz 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 Banovetz affiliated with any hospitals?

According to CMS data, James Banovetz is affiliated with Aspirus Stevens Point Hospital & Clinics, Inc. and Aspirus Wausau Hospital.

When was this NPI record last updated?

The NPPES record for James Banovetz was last updated on May 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.