JAMES MARTIN FOX M.D.
NPI 1740275379
Internal Medicine - Cardiovascular Disease in Traverse City, MI

Q: What is James Fox's NPI number?

The NPI number for James Fox is 1740275379. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Q: What is James Fox's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for James Fox was last updated on December 18, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment

1200 SIXTH ST, SUITE 200, TRAVERSE CITY, MI 49684(231) 935-5800(231) 935-5799 Get Directions Write a Review

NPPES record last updated: December 18, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 18, 2020, Feb 12, 2020, May 18, 2017 (3 updates tracked since 2017).

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About James Martin Fox M.d. NPPES

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

JAMES MARTIN FOX M.D. (NPI 1740275379) is an individual cardiovascular disease provider in Traverse City, Michigan, licensed in Michigan (4301080842) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Munson Healthcare Grayling Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1740275379

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameJAMES MARTIN FOXCredential: M.D.

Location Address1200 SIXTH ST, SUITE 200Traverse City, MI 49684-2369

Mailing Address2891 Momentum PlChicago, IL 60689-5328 · (231) 935-6080 · Fax (231) 935-6081

Phone(231) 935-5800

Fax(231) 935-5799

Sole ProprietorNo

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1994

Enumeration DateSeptember 20, 2005

Last NPPES UpdateDecember 18, 20203 updates tracked since enumeration

NPPES CertifiedDecember 18, 2020

✔ NPI 1740275379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in MI · 4301080842

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1200 SIXTH ST, Traverse City, MI 49684

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Secondary Practice Locations 4

Location 11100 E Michigan AveGrayling, MI 49738-1312 · Phone (989) 348-5461 · Fax (989) 348-5724

Location 22585 W Houghton Lake DrPrudenville, MI 48651-9624 · Phone (989) 366-2900 · Fax (989) 366-1166

Location 31250 E Michigan AveGrayling, MI 49738-7074 · Phone (989) 348-0550 · Fax (989) 348-0473

Location 4234 Lake StRoscommon, MI 48653-9203 · Phone (989) 275-1200 · Fax (989) 275-1210

Other Identifiers 1

Medicaid4425725MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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

James Martin Fox 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 ID9931198520

PECOS Enrollment IDI20040510000215

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 23

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

862 services627 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

319 services316 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.

249 services216 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

89 services85 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.

45 services23 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

44 services44 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.

42 services41 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

41 services41 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.

40 services27 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.

34 services33 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

32 services32 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.

30 services30 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

29 services29 patients

Ultrasound of heart during rest, exercise and/or drug-induced stress with report 93350

This procedure involves using ultrasound imaging to view your heart at rest, during exercise, and/or under drug-induced stress. It helps assess how well your heart responds to exertion. A report of the findings is provided after the test.

24 services24 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

23 services22 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

21 services21 patients

Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

19 services19 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

18 services16 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

16 services16 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

15 services14 patients

Insertion of tube in right heart chambers for measurement 93451

This procedure involves placing a small, flexible tube into the right side of your heart. It helps assess how your heart is functioning by measuring pressures within the heart chambers. It's a key tool in diagnosing certain heart conditions.

12 services12 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.

12 services12 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Munson Healthcare Grayling Hospital

Acute Care Hospitals · Grayling, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230058

Location1100 E Michigan AveGrayling, MI 49738 · Crawford County

Emergency services Birthing friendly

Munson Healthcare Cadillac Hospital

Acute Care Hospitals · Cadillac, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230081

Location400 Hobart StCadillac, MI 49601 · Wexford County

Emergency services Birthing friendly

Munson Medical Center

Acute Care Hospitals · Traverse City, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230097

Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County

Emergency services Birthing friendly

Munson Healthcare Otsego Memorial Hospital

Acute Care Hospitals · Gaylord, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230133

Location825 N Center AveGaylord, MI 49735 · Otsego County

Birthing friendly

Kalkaska Memorial Health Center

Critical Access Hospitals · Kalkaska, MI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number231301

Location419 S CoralKalkaska, MI 49646 · Kalkaska County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 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

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%707 patients5/55-star benchmark: 100%

Coronary Artery Disease (CAD): Antiplatelet Therapy

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel

96%581 patients4/55-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%221 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.

99%1,151 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

86%807 patients4/55-star benchmark: 100%

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…

14%44 patients1/55-star benchmark: 96%

Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet

Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…

97%499 patients4/55-star benchmark: 100%

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.

96%129 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.

32%738 patients2/55-star benchmark: 99%

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…

90%738 patients4/55-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…

17%738 patients2/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 1,376 patients

3%1,376 patients4/55-star benchmark: 100%

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.

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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.

DR. REBECCA HAGERTY DO

Family Medicine (Adult Medicine)

1200 SIXTH ST, STE 400
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 392-0650

DAVID K MACINTOSH D.O.

Internal Medicine (Cardiovascular Disease)

1200 SIXTH ST, SUITE 200
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-5800

GRAND TRAVERSE WOMENS CLINIC

Midwife

1200 SIXTH ST, STE 400
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 392-0650

THOMAS W CROSBY M.D.

Internal Medicine (Cardiovascular Disease)

1200 SIXTH ST, SUITE 200
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-5800

BARBARA ROGERS

Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)

1200 SIXTH ST, STE 400
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 392-0655

GRAND TRAVERSE WOMENS CLINIC

Nurse Practitioner (Obstetrics & Gynecology)

1200 SIXTH ST, STE 400
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 392-0655

JOHN N. BEATTIE M.D.

Internal Medicine (Cardiovascular Disease)

1200 SIXTH ST, SUITE 200
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-5800

KEVIN J CLAYTON D.O

Internal Medicine (Cardiovascular Disease)

1200 SIXTH ST, SUITE 200
TRAVERSE CITY, MI 49684

Grand Traverse County (231) 935-5800

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 Fox's NPI number?

The NPI number for James Fox is 1740275379. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is James Fox located?

James Fox practices at 1200 Sixth St Suite 200, Traverse City, MI 49684. The listed phone number is (231) 935-5800.

What is James Fox's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is James Fox enrolled in Medicare?

Yes. James Fox 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 Fox accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list James Fox 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 Fox affiliated with any hospitals?

According to CMS data, James Fox is affiliated with Munson Healthcare Grayling Hospital, Munson Healthcare Cadillac Hospital, Munson Medical Center, Munson Healthcare Otsego Memorial Hospital and Kalkaska Memorial Health Center.

When was this NPI record last updated?

The NPPES record for James Fox was last updated on December 18, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.