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DR. JAMES DOUGLAS BURLEIGH DO
NPI 1689963373
Internal Medicine - Hospice and Palliative Medicine in West Reading, PA

Active since April 04, 2011PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
6TH AVENUE AND SPRUCE STREET, WEST READING, PA 19611(484) 628-5281 Get Directions Write a Review

NPPES record last updated: April 12, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. James Douglas Burleigh Do NPPES

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

DR. JAMES DOUGLAS BURLEIGH DO (NPI 1689963373) is an individual hospice and palliative medicine provider in West Reading, Pennsylvania, licensed in Pennsylvania (OS017614) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2011).

NPPES Registry Identity

NPI1689963373
Entity TypeIndividualMale
Primary Taxonomy207RH0002X
Provider Legal NameDR. JAMES DOUGLAS BURLEIGHCredential: DO
Location Address6TH AVENUE AND SPRUCE STREETWest Reading, PA 19611-1428
Mailing AddressPo Box 13579Reading, PA 19612-3579 · (484) 628-0799
Phone(484) 628-5281
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2011
Enumeration DateApril 4, 2011
Last NPPES UpdateApril 12, 2021
NPPES CertifiedMarch 22, 2021
✔ NPI 1689963373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RH0002X
License✔ Licensed in PA · OS017614
Definition
An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
6TH AVENUE AND SPRUCE STREET, West Reading, PA 19611
Open in Google Maps ↗

Accepted Insurance

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

Dr. James Douglas Burleigh Do 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 ID5698086544
PECOS Enrollment IDI20150618000592
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 Burleigh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tower Health Medical Group
1.2 mi
Trauma Surgery
420 S 5TH AVE
West Reading, PA 19611
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,473 clinicians in this Medicare group
NPI 1063589273 (484) 628-4879
Phoenixville Clinic Company LLC
22 mi
Vascular Surgery
420 W LINFIELD TRAPPE RD, STE 1100
Limerick, PA 19468
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 529 clinicians in this Medicare group
NPI 1790746345 (610) 495-2550

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 5

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.

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.
227 services198 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.
118 services73 patients
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.
47 services33 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services20 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

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.

81.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.56
Promoting Interoperability97
Improvement Activities40
Cost65.23

Reported Quality Measures

Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 30 patients
100%37 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.

RICHARD LOYND D.O.
Internal Medicine
6TH AVENUE AND SPRUCE STREET
WEST READING, PA 19611
Berks County (484) 628-8640
DR. VICENTE CORTES MD
Surgery (Surgical Critical Care)
6TH AVENUE AND SPRUCE STREET, TRAUMA ADMINISTRATION, B4 SOUTH
WEST READING, PA 19611
Berks County (484) 628-4888
RHPN MIDWIVES
General Acute Care Hospital
6TH AVENUE AND SPRUCE STREET
WEST READING, PA 19611
Berks County (484) 628-8000
BENJAMIN MATTHEW KLINE MD
Anesthesiology
6TH AVENUE AND SPRUCE STREET, READING ANESTHESIA ASSOCIATES LTD
WEST READING, PA 19611
Berks County (610) 988-8589
TAMMY LAFFERTY CRNP
Nurse Practitioner (Gerontology)
6TH AVENUE AND SPRUCE STREET
WEST READING, PA 19611
Berks County (484) 628-5455
DR. GREGORY J OWSIK M.D.
Emergency Medicine
6TH AVENUE AND SPRUCE STREET
READING, PA 19611
Berks County (484) 628-3637
MORGAN A RAGSDALE CRNA
Nurse Anesthetist, Certified Registered
6TH AVENUE AND SPRUCE STREET
WEST READING, PA 19611
Berks County (484) 628-8269
MARTHA H CONNOLLY LCSW
Social Worker (Clinical)
6TH AVENUE AND SPRUCE STREET
WEST READING, PA 19611
Berks County (610) 988-8070

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 Burleigh's NPI number?

The NPI number for James Burleigh is 1689963373. It was assigned to this individual provider in the NPPES registry on April 4, 2011.

Where is James Burleigh located?

James Burleigh practices at 6th Avenue And Spruce Street, West Reading, PA 19611. The listed phone number is (484) 628-5281.

What is James Burleigh's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207RH0002X.

Is James Burleigh enrolled in Medicare?

Yes. James Burleigh 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 Burleigh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Burleigh reassigns Medicare benefits to 2 organizations: Tower Health Medical Group (West Reading, PA) and Phoenixville Clinic Company LLC (Limerick, PA). 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 Burleigh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Burleigh accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list James Burleigh 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 Burleigh affiliated with any hospitals?

According to CMS data, James Burleigh is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for James Burleigh was last updated on April 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.