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MR. JAMES PAUL KOWALSKI FNP-C
NPI 1801418561
Nurse Practitioner - Family in Chicago, IL

Active since May 15, 2020PECOS EnrolledAccepts Medicare Assignment
7.11/100
CMS Quality Rating
445 E ILLINOIS ST UNIT 5106, CHICAGO, IL 60611(217) 619-6042 Get Directions Write a Review

NPPES record last updated: May 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. James Paul Kowalski Fnp-c NPPES

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

MR. JAMES PAUL KOWALSKI FNP-C (NPI 1801418561) is an individual family provider in Chicago, Illinois, licensed in Illinois (209021284) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1801418561
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. JAMES PAUL KOWALSKICredential: FNP-C
Location Address445 E ILLINOIS ST UNIT 5106Chicago, IL 60611-5371
Mailing Address445 E Illinois St Unit 5106Chicago, IL 60611-5371 · (217) 619-6042
Phone(217) 619-6042
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMay 15, 2020
NPPES CertifiedMay 15, 2020
✔ NPI 1801418561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209021284
445 E ILLINOIS ST UNIT 5106, Chicago, IL 60611
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Mr. James Paul Kowalski Fnp-c 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 ID2961828462
PECOS Enrollment IDI20200814000428, I20220216002004
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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
660 services247 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
154 services104 patients
Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes 99345
A new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.
113 services113 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
44 services42 patients
Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month 99491
Chronic care management services involve a healthcare professional personally providing care for patients with two or more chronic conditions. This service, offered monthly, focuses on the first 30 minutes of care, helping manage and coordinate the patient's health needs.
43 services37 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
24 services24 patients

Hospital Affiliations CMS Care Compare

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

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140010
Location2650 Ridge AveEvanston, IL 60201 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60611 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

7.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Promoting Interoperability0
Improvement Activities0
Cost23.72

Referred Medical Equipment & Supplies CMS DME claims 14

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
2 suppliers15 claims18 services$6.56 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
3 suppliers40 claims40 services$38.11 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress E0294
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$52.28 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$15.75 avg. paid by Medicare
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955
DME-Wheelchairs · category DD021N
2 suppliers34 claims34 services$9.74 avg. paid by Medicare
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each E1226
DME-Wheelchairs · category DD021N
2 suppliers30 claims30 services$30.05 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 Kowalski's NPI number?

The NPI number for James Kowalski is 1801418561. It was assigned to this individual provider in the NPPES registry on May 15, 2020.

Where is James Kowalski located?

James Kowalski practices at 445 E Illinois St Unit 5106, Chicago, IL 60611. The listed phone number is (217) 619-6042.

What is James Kowalski's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is James Kowalski enrolled in Medicare?

Yes. James Kowalski 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 Kowalski accept?

Health plans from CareSource list James Kowalski 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 Kowalski affiliated with any hospitals?

According to CMS data, James Kowalski is affiliated with Northshore University Healthsystem - Evanston Hospital.

When was this NPI record last updated?

The NPPES record for James Kowalski was last updated on May 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.