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JAMES CLIFTON CRITTENDEN M.D.
NPI 1780687855
Internal Medicine in Bay St Louis, MS

Active since May 23, 2005PECOS EnrolledAccepts Medicare Assignment
93.1/100
CMS Quality Rating
1001 BENIGNO LANE, BAY ST LOUIS, MS 39520(228) 467-1414(228) 467-5863 Get Directions Write a Review

NPPES record last updated: July 29, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About James Clifton Crittenden M.d. NPPES

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

JAMES CLIFTON CRITTENDEN M.D. (NPI 1780687855) is an individual internal medicine provider in Bay St Louis, Mississippi, licensed in Mississippi (08719) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of University Of Mississippi School Of Medicine (1979).

NPPES Registry Identity

NPI1780687855
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJAMES CLIFTON CRITTENDENCredential: M.D.
Location Address1001 BENIGNO LANEBay St Louis, MS 39520
Mailing AddressP O Box 3210Bay St Louis, MS 39521 · (228) 467-1414 · Fax (228) 467-5863
Phone(228) 467-1414
Fax(228) 467-5863
Sole ProprietorYes
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 1979
Enumeration DateMay 23, 2005
Last NPPES UpdateJuly 29, 2015
✔ NPI 1780687855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MS · 08719
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1001 BENIGNO LANE, Bay St Louis, MS 39520
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Other Identifiers 3

Medicare PIN110000066MS
Medicare UPINB30284MS
Medicaid00010920MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Clifton Crittenden 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 ID9739251257
PECOS Enrollment IDI20080627000445
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.

Medicare Billing Reassignments

2

Medicare enrollment records show James Crittenden reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Memorial Hospital At Gulfport
0.2 mi
Internal Medicine
835 THAMES AVE
Bay St Louis, MS 39520
  • Reassigned Medicare billing, Mississippi enrollment
  • 731 clinicians in this Medicare group
NPI 1518394089 (228) 466-4977
Grenada Physician Services, LLC
241 mi
Hospitalist
960 AVENT DR
Grenada, MS 38901
  • Reassigned Medicare billing, Mississippi enrollment
  • 44 clinicians in this Medicare group
NPI 1932762721 (662) 227-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

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.
618 services195 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
155 services155 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
80 services17 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 services32 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
34 services34 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
19 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Memorial Hospital At Gulfport

Acute Care Hospitals · Gulfport, MS
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number250019
Location4500 13th StreetGulfport, MS 39502 · Harrison County
Emergency services Birthing friendly

Ochsner Medical Center-Hancock

Acute Care Hospitals · Bay Saint Louis, MS
OwnershipGovernment - Local
CMS Certification Number250162
Location149 Drinkwater BlvdBay Saint Louis, MS 39520 · Hancock County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39520 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
$120.41 typical visit price
range $51.65 – $159.18
Typical copayment $30.10 (range $12.91 – $39.79)
Most-billed visit code 99204
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

93.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality83.08
Promoting Interoperability88
Improvement Activities40

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%62 patients5/55-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
81%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.
86%4,618 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
29%425 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
71%1,058 patients3/55-star benchmark: 97%
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% · 425 patients
6%425 patients3/55-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.

Referred Medical Equipment & Supplies CMS DME claims 15

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers19 claims30 services$5.87 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
6 suppliers22 claims130 services$18.90 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
8 suppliers27 claims27 services$53.80 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
8 suppliers22 claims22 services$17.76 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
7 suppliers25 claims25 services$16.80 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers26 claims147 services$2.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Crittenden's NPI number?

The NPI number for James Crittenden is 1780687855. It was assigned to this individual provider in the NPPES registry on May 23, 2005.

Where is James Crittenden located?

James Crittenden practices at 1001 Benigno Lane, Bay St Louis, MS 39520. The listed phone number is (228) 467-1414.

What is James Crittenden's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Crittenden enrolled in Medicare?

Yes. James Crittenden 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.

Which organizations bill Medicare for James Crittenden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Crittenden reassigns Medicare benefits to 2 organizations: Memorial Hospital At Gulfport (Bay St Louis, MS) and Grenada Physician Services, LLC (Grenada, MS). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Crittenden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Crittenden accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 4 other insurers list James Crittenden 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 Crittenden affiliated with any hospitals?

According to CMS data, James Crittenden is affiliated with Memorial Hospital At Gulfport and Ochsner Medical Center-Hancock.

When was this NPI record last updated?

The NPPES record for James Crittenden was last updated on July 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.