JAMES CHARLES RUMFOLA NP
NPI 1790284974
Nurse Practitioner - Family in Baton Rouge, LA
NPI Status: Active since February 02, 2018
Contact Information
16 INFIRMARY ROAD
BATON ROUGE, LA
ZIP 70803
Phone: (225) 578-6716
Fax: (225) 578-0596
- Individual
- Male
- Nurse Practitioner
- Family
- Accepts Insurance
- PECOS Enrolled
About JAMES RUMFOLA
This page provides the complete NPI Profile along with additional information for James Rumfola, a provider established in Baton Rouge, Louisiana with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1790284974 assigned on February 2018. The practitioner's primary taxonomy code is 363LF0000X with license number AP09776 (LA). The provider is registered as an individual and his NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization.
- NPI
- 1790284974
- Provider Name
- JAMES CHARLES RUMFOLA NP
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 16 INFIRMARY ROAD BATON ROUGE, LA 70803
- Location Phone
- (225) 578-6716
- Location Fax
- (225) 578-0596
- Mailing Address
- PO BOX 80093 BATON ROUGE, LA 70898
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-02-2018
- Last Update Date
- 03-18-2025
- Code Navigator
A nurse practitioner (NP) like James Rumfola is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Secondary Locations
- 5000 Hennessy Blvd
Baton Rouge, LA 70808
(225) 765-7163
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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- AP09776
- License State
- LA
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
- Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
- Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
- Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
- Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
- Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (BR) - POS
- Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (M) - POS
- Precision Blue 90/70 $9900 with 2 $0 PCP Virtual Visits (M) HSA Eligible - POS
- Precision Blue Copay (PCP) 50/50 $7500 Standardized (BR) HSA Eligible - POS
- Precision Blue Copay (PCP) 50/50 $7500 Standardized (M) HSA Eligible - POS
- Precision Blue Copay (PCP) 60/40 $6000 Standardized (BR) - POS
- Precision Blue Copay (PCP) 60/40 $6000 Standardized (M) - POS
- Precision Blue Copay (PCP) 75/55 $2000 Standardized (BR) - POS
- Precision Blue Copay (PCP) 75/55 $2000 Standardized (M) - POS
- Signature Blue 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Signature Blue Copay (PCP) 60/40 $6000 Standardized - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
James Rumfola 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
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
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 70803 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.6
- Minimum New Patient Price $53.43
- Maximum New Patient Price $164.73
- Average New Patient Copayment $20.9
- Minimum New Patient Copayment $13.35
- Maximum New Patient Copayment $41.18
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.09
- Minimum Established Patient Price $16.64
- Maximum Established Patient Price $133.62
- Average Established Patient Copayment $23.77
- Minimum Established Patient Copayment $4.16
- Maximum Established Patient Copayment $33.4
* 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.
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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 1790284974, we treat the final digit (4) 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 76. The final step is to find the difference between that total and the next multiple of ten (80 - 76 = 4).
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 76 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790284974, enumerated as an "individual" on February 02, 2018.
The provider is located at 16 INFIRMARY ROAD BATON ROUGE, LA 70803 and the phone number is (225) 578-6716.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: AmeriHealth Caritas Next, Blue Cross and Blue. Please consult your insurance carrier or call the provider to verify.
