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MONICA KAY JAMES M.D.
NPI 1811374119
Colon & Rectal Surgery in Pontiac, MI

Active since May 06, 2015PECOS EnrolledAccepts Medicare Assignment
44555 WOODWARD AVE STE 501, PONTIAC, MI 48341(248) 338-7171 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 25, 2022, Jul 2, 2021 (2 updates tracked since 2021).

About Monica Kay James M.d. NPPES

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

MONICA KAY JAMES M.D. (NPI 1811374119) is an individual colon & rectal surgery provider in Pontiac, Michigan, licensed in Michigan (4301503536) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, is affiliated with Trinity Health Oakland Hospital, and is a graduate of Michigan State University College Of Human Medicine (2015).

NPPES Registry Identity

NPI1811374119
Entity TypeIndividualFemale
Primary Taxonomy208C00000X
Provider Legal NameMONICA KAY JAMESCredential: M.D.
Location Address44555 WOODWARD AVE STE 501Pontiac, MI 48341-5039
Mailing Address2220 Willow Beach StKeego Harbor, MI 48320-1219 · (248) 338-7171
Phone(248) 338-7171
Sole ProprietorYes
Medical School CMSMichigan State University College Of Human MedicineGraduated 2015
Enumeration DateMay 6, 2015
Last NPPES UpdateJanuary 25, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2022
✔ NPI 1811374119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in MI · 4301503536
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
44555 WOODWARD AVE STE 501, Pontiac, MI 48341
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Other Names 1

Former Name (1)Monica Kay Zipple

Other Identifiers 1

MedicaidIN PROGRESSMI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Monica Kay 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 ID6204148364
PECOS Enrollment IDI20210617000723
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 11

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This 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.
86 services86 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.
55 services52 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
47 services33 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
34 services33 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
32 services32 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
25 services18 patients

Hospital Affiliations CMS Care Compare

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

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230029
Location44405 Woodward AvePontiac, MI 48341 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48341 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

Other Providers at the Same Location NPPES

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

IHA OLMA SPECIALTY SERVICES LLC
Surgery
44555 WOODWARD AVE STE 501
PONTIAC, MI 48341
Oakland County (248) 338-7171

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 Monica James's NPI number?

The NPI number for Monica James is 1811374119. It was assigned to this individual provider in the NPPES registry on May 6, 2015. The provider is also known as Monica Kay Zipple.

Where is Monica James located?

Monica James practices at 44555 Woodward Ave Ste 501, Pontiac, MI 48341. The listed phone number is (248) 338-7171.

What is Monica James's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Monica James enrolled in Medicare?

Yes. Monica 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 Monica James accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Monica 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 Monica James affiliated with any hospitals?

According to CMS data, Monica James is affiliated with Trinity Health Oakland Hospital.

When was this NPI record last updated?

The NPPES record for Monica James was last updated on January 25, 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.