DR. JAMES BRECHEISEN MD
NPI 1750802823
Family Medicine in Springfield, MO

NPI Status: Active since June 29, 2017

Contact Information

1423 N JEFFERSON AVE # B100
SPRINGFIELD, MO
ZIP 65802
Phone: (417) 269-8817
Fax: (417) 269-8744

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 9
Family Medicine
Accepts Insurance
May Accept Medicare Approved Payment
PECOS Enrolled

About JAMES BRECHEISEN

This page provides the complete NPI Profile along with additional information for James Brecheisen, a primary care provider established in Springfield, Missouri with a medical specialization in Family Medicine and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1750802823 assigned on June 2017. The practitioner's primary taxonomy code is 207Q00000X with license number 2017021159 (MO). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1750802823
Provider Name: DR. JAMES BRECHEISEN MD
Gender: Male
Entity Type: Individual
Location Address: 1423 N JEFFERSON AVE # B100 SPRINGFIELD, MO 65802
Location Phone: (417) 269-8817
Location Fax: (417) 269-8744
Mailing Address: 1423 N JEFFERSON AVE # B100 SPRINGFIELD, MO 65802
Mailing Phone: (417) 269-8817
Mailing Fax: (417) 269-8744
Medical School Name: OTHER
Graduation Year: 2017
Is Sole Proprietor?: No
Enumeration Date: 06-29-2017
Last Update Date: 07-21-2022
Code Navigator

A primary care provider (PCP) like James Brecheisen sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
License No.: 2017021159
License State: MO
Taxonomy Description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Arkansas Blue Cross and Blue Shield

Bronze Exp Standardized - PPO
Bronze Value - PPO
Gold Standardized - PPO
Silver AH - PPO
Silver Standardized - PPO
Silver Value - PPO
Dental Gold - PPO
Dental Gold Plus Vision - PPO
Dental Pediatric - PPO
Dental Platinum - PPO
Dental Platinum Plus Vision - PPO
Dental Platinum Premium - PPO
Dental Platinum Premium Plus Vision - PPO
Dental Silver - PPO

Health Advantage

HA Bronze Exp Standardized - POS
HA Bronze Suitcase - POS
HA Gold Standardized - POS
HA Silver AH - POS
HA Silver Premier Suitcase - POS
HA Silver Standardized - POS

Octave

Octave Bronze Exp Standardized - POS
Octave Bronze Value - POS
Octave Gold Standardized - POS
Octave Silver AH - POS
Octave Silver Classic Suitcase - POS
Octave Silver Standardized - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

James Brecheisen is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

James Brecheisen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 547516189
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20200619000451
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 65802 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $81.64
Minimum New Patient Price $52.28
Maximum New Patient Price $161.24

Average New Patient Copayment $20.41
Minimum New Patient Copayment $13.07
Maximum New Patient Copayment $40.31

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $93.24
Minimum Established Patient Price $16.3
Maximum Established Patient Price $131.05

Average Established Patient Copayment $23.31
Minimum Established Patient Copayment $4.07
Maximum Established Patient Copayment $32.76

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	5	0	8	0	2	8	2	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	10	0	16	0	4	8	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 6 + 0 + 4 + 8 + 4 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 3									3

The NPI number 1750802823 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.