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KRISTEN JAMES M.D.
NPI 1770977100
Obstetrics & Gynecology in Glen Carbon, IL

Active since March 24, 2015PECOS EnrolledAccepts Medicare Assignment
74.42/100
CMS Quality Rating
2246 S STATE ROUTE 157 STE 100, GLEN CARBON, IL 62034(618) 288-9251(618) 798-8129 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 6, 2022, Aug 18, 2019, Jul 8, 2019 (3 updates tracked since 2019).

About Kristen James M.d. NPPES

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

KRISTEN JAMES M.D. (NPI 1770977100) is an individual obstetrics & gynecology provider in Glen Carbon, Illinois, licensed in Illinois (036.150200) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, is affiliated with Anderson Hospital, and is a graduate of University Of Missouri, Kansas City, School Of Medicine (2015).

NPPES Registry Identity

NPI1770977100
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameKRISTEN JAMESCredential: M.D.
Location Address2246 S STATE ROUTE 157 STE 100Glen Carbon, IL 62034-1717
Mailing Address2246 S State Route 157 Ste 100Glen Carbon, IL 62034-1717 · (618) 288-9251
Phone(618) 288-9251
Fax(618) 798-8129
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 2015
Enumeration DateMarch 24, 2015
Last NPPES UpdateJanuary 6, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2022
✔ NPI 1770977100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in IL · 036.150200
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
2246 S STATE ROUTE 157 STE 100, Glen Carbon, IL 62034
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Accepted Insurance

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

Kristen James 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 ID6406183664
PECOS Enrollment IDI20190809002203
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 2

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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
25 services25 patients
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory Q0091
A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.
18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Anderson Hospital

Acute Care Hospitals · Maryville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly

Community Hospital Of Staunton

Critical Access Hospitals · Staunton, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141306
Location400 N Caldwell StStaunton, IL 62088 · Macoupin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62034 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
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.

74.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.31
Promoting Interoperability85
Improvement Activities40
Cost56.92

Other Providers at the Same Location NPPES 2

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

BRYSON WHALEN M.D.
Obstetrics & Gynecology
2246 S STATE ROUTE 157 STE 100
GLEN CARBON, IL 62034
Madison County (618) 288-9251
DENNIS M HURFORD MD
Obstetrics & Gynecology
2246 S STATE ROUTE 157 STE 100
GLEN CARBON, IL 62034
Madison County (618) 288-9251

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 Kristen James's NPI number?

The NPI number for Kristen James is 1770977100. It was assigned to this individual provider in the NPPES registry on March 24, 2015.

Where is Kristen James located?

Kristen James practices at 2246 S State Route 157 Ste 100, Glen Carbon, IL 62034. The listed phone number is (618) 288-9251.

What is Kristen James's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kristen James enrolled in Medicare?

Yes. Kristen James 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 Kristen James accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Kristen James 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 Kristen James affiliated with any hospitals?

According to CMS data, Kristen James is affiliated with Anderson Hospital and Community Hospital Of Staunton.

When was this NPI record last updated?

The NPPES record for Kristen James was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.