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DR. JAMES L TOUSSAINT M.D.
NPI 1760430235
Internal Medicine - Gastroenterology in Charlotte, NC

Active since May 05, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
15830 JOHN J DELANEY DR, SUITE 175, CHARLOTTE, NC 28277(704) 377-4009 Get Directions Write a Review

NPPES record last updated: April 4, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James L Toussaint M.d. NPPES

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

DR. JAMES L TOUSSAINT M.D. (NPI 1760430235) is an individual gastroenterology provider in Charlotte, North Carolina, licensed in North Carolina (37961) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and is a graduate of University Of North Dakota School Of Medicine (1984).

NPPES Registry Identity

NPI1760430235
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. JAMES L TOUSSAINTCredential: M.D.
Location Address15830 JOHN J DELANEY DR, SUITE 175Charlotte, NC 28277-3294
Mailing AddressPo Box 497Huntersville, NC 28070-0497 · (704) 377-4009
Phone(704) 377-4009
Sole ProprietorNo
Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 1984
Enumeration DateMay 5, 2006
Last NPPES UpdateApril 4, 2012
✔ NPI 1760430235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in NC · 37961
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
15830 JOHN J DELANEY DR, Charlotte, NC 28277
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Other Identifiers 3

Medicare ID-Type Unspecified213912ANC
Medicaid7983665NC
Medicare UPIND80571NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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 L Toussaint 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 ID2961398516
PECOS Enrollment IDI20070509000677
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 7

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.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
142 services141 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.
135 services108 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
93 services89 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
60 services60 patients
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249
This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.
26 services26 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.
21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340171
Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Ballantyne Medical Center

Acute Care Hospitals · Charlotte, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number340195
Location10905 Providence Road WCharlotte, NC 28277 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims

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

Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
2 suppliers11 claims370 services$0.22 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 4

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

CAROLINA DISC ASSOCIATES, P.C.
Chiropractor
15830 JOHN J DELANEY DR, SUITE 250
CHARLOTTE, NC 28277
Mecklenburg County (704) 541-5555
DR. THOMAS J GAVIGAN M.D.
Internal Medicine (Gastroenterology)
15830 JOHN J DELANEY DR, SUITE 175
CHARLOTTE, NC 28277
Mecklenburg County (704) 377-4009
SLEEP SUCCESS TECHNOLOGY, INC.
Clinic/Center (Multi-Specialty)
15830 JOHN J DELANEY DR, SUITE 125
CHARLOTTE, NC 28277
Mecklenburg County (704) 752-3295
BRUCE HOWARD MARKO M.D.
Specialist
15830 JOHN J DELANEY DR, STE 250
CHARLOTTE, NC 28277
Mecklenburg County (704) 295-9099

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 Toussaint's NPI number?

The NPI number for James Toussaint is 1760430235. It was assigned to this individual provider in the NPPES registry on May 5, 2006.

Where is James Toussaint located?

James Toussaint practices at 15830 John J Delaney Dr Suite 175, Charlotte, NC 28277. The listed phone number is (704) 377-4009.

What is James Toussaint's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is James Toussaint enrolled in Medicare?

Yes. James Toussaint 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 Toussaint accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list James Toussaint 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 Toussaint affiliated with any hospitals?

According to CMS data, James Toussaint is affiliated with Novant Health Presbyterian Medical Center, Novant Health Matthews Medical Center and Novant Health Ballantyne Medical Center.

When was this NPI record last updated?

The NPPES record for James Toussaint was last updated on April 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.