JAMES HINES M.D.
NPI 1770575631
Internal Medicine - Cardiovascular Disease in Phoenix, AZ
NPI Status: Active since August 17, 2005
Contact Information
340 E PALM LN
SUITE 175
PHOENIX, AZ
ZIP 85004
Phone: (602) 386-1100
Fax: (602) 386-1150
- Individual
- Male
- Years of Experience 48
- Internal Medicine
- Cardiovascular Disease
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JAMES HINES
This page provides the complete NPI Profile along with additional information for James Hines, an internist established in Phoenix, Arizona with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 48 years of experience. He graduated from Northwestern University Feinberg Medical School in 1978. The healthcare provider is registered in the NPI registry with number 1770575631 assigned on August 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 20960 (AZ). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1770575631
- Provider Name
- JAMES HINES M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 340 E PALM LN SUITE 175 PHOENIX, AZ 85004
- Location Phone
- (602) 386-1100
- Location Fax
- (602) 386-1150
- Mailing Address
- 340 E PALM LN SUITE 175 PHOENIX, AZ 85004
- Mailing Phone
- (602) 386-1100
- Mailing Fax
- (602) 386-1150
- Medical School Name
- NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
- Graduation Year
- 1978
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-17-2005
- Last Update Date
- 11-28-2007
- Code Navigator
An internist like James Hines is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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
Internal Medicine Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 20960
- License State
- AZ
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
- AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
- AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO
- AZ Blue EverydayHealth Prosano Silver ($0 Prosano Health Visits) - HMO
- AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
- AZ Blue Portfolio Bronze HSA Focus - HMO
- AZ Blue StandardHealth Bronze Focus - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Buena Salud Bronce Simple Para Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Simple - HMO
- Gold Simple Diabetes - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| C43470 | MEDICARE UPIN (02) | AZ | |
| 060017047 | OTHER (01) | AZ | RAILROAD MEDICARE PIN |
| Z06WCHJB06 | MEDICARE PIN (08) | AZ | |
| 112102 | MEDICAID (05) | AZ |
Medicare Participation & PECOS Enrollment Status
James Hines is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
James Hines 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: 9436199791
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: I20050505000568
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? Yes
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.
Blood test, clotting time
Complete ultrasound study of arm and leg arteries
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Heart rhythm recording continous external ekg over more than 48 hours up to 7 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Injection, regadenoson, 0.1 mg
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Programming of dual lead pacemaker system
Programming of single lead pacemaker system
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Technetium tc-99m sestamibi, diagnostic, per study dose
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
This service was performed 229 times for 37 patientsThis procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.
This service was performed 22 times for 14 patientsThis 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.
This service was performed 74 times for 67 patientsThis 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.
This service was performed 1,453 times for 818 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 27 times for 23 patientsAn exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
This service was performed 165 times for 160 patientsThis procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.
This service was performed 18 times for 18 patientsA heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.
This service was performed 20 times for 20 patientsRegadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
This service was performed 237 times for 60 patientsThis 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.
This service was performed 15 times for 15 patientsThis 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.
This service was performed 22 times for 22 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 77 times for 77 patientsProgramming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.
This service was performed 86 times for 40 patientsProgramming of a single lead pacemaker system involves adjusting the pacemaker's settings to suit your heart's unique needs. This is done using a special device that communicates with the pacemaker, ensuring it helps your heart beat at an optimal rate.
This service was performed 27 times for 15 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 1,406 times for 861 patientsTechnetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.
This service was performed 143 times for 72 patientsThis 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.
This service was performed 227 times for 216 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $17.31 for an established patient copayment.
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 85004 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $127.71
- Minimum New Patient Price $55.44
- Maximum New Patient Price $168.6
- Average New Patient Copayment $31.92
- Minimum New Patient Copayment $13.86
- Maximum New Patient Copayment $42.15
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.24
- Minimum Established Patient Price $17.72
- Maximum Established Patient Price $137.41
- Average Established Patient Copayment $17.31
- Minimum Established Patient Copayment $4.43
- Maximum Established Patient Copayment $34.35
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Anticoagulant Management Improvements | Yes | N/A |
| Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program. | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| e-Prescribing | 91% | 9970 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 100% | 243 |
| 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 at least one transition of care or referral. | ||
| Medication Reconciliation | 75% | 857 |
| 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. | ||
| Patient-Specific Education | 33% | 3105 |
| 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. | ||
| Provide Patient Access | 71% | 3105 |
| 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 certain information. | ||
| Secure Messaging | 66% | 3105 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Reviews for JAMES HINES M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1770575631, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
PHOENIX, AZ 85004
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770575631, enumerated as an "individual" on August 17, 2005.
The provider is located at 340 E PALM LN SUITE 175 PHOENIX, AZ 85004 and the phone number is (602) 386-1100.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Blue Cross. Please consult your insurance carrier or call the provider to verify.
