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J. MARCUS DOWNS MD
NPI 1811922610
Colon & Rectal Surgery in Dallas, TX

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
89.44/100
CMS Quality Rating
8315 WALNUT HILL LN, SUITE 220, DALLAS, TX 75231(214) 363-6123(866) 644-6809 Get Directions Write a Review

NPPES record last updated: March 30, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 30, 2021, Oct 13, 2020 (2 updates tracked since 2020).

About J. Marcus Downs Md NPPES

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

J. MARCUS DOWNS MD (NPI 1811922610) is an individual colon & rectal surgery provider in Dallas, Texas, licensed in Texas (J3086) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Texas Health Presbyterian Hospital Dallas, and is a graduate of University Of Missouri, Columbia School Of Medicine (1983).

NPPES Registry Identity

NPI1811922610
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameJ. MARCUS DOWNSCredential: MD
Location Address8315 WALNUT HILL LN, SUITE 220Dallas, TX 75231-4218
Mailing Address16980 Dallas Pkwy Ste 200Dallas, TX 75248-1974 · (214) 348-5288 · Fax (214) 343-3689
Phone(214) 363-6123
Fax(866) 644-6809
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1983
Enumeration DateJuly 11, 2006
Last NPPES UpdateMarch 30, 20212 updates tracked since enumeration
NPPES CertifiedOctober 13, 2020
✔ NPI 1811922610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in TX · J3086
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.

8315 WALNUT HILL LN, Dallas, TX 75231
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Other Identifiers 2

Medicaid099181203TX
Medicaid099181201TX

Accepted Insurance

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

J. Marcus Downs Md 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 ID9032193545
PECOS Enrollment IDI20100512000996
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.
105 services105 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.
94 services80 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.
90 services90 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
56 services56 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.
46 services46 patients
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.
35 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Texas Health Presbyterian Hospital Dallas

Acute Care Hospitals · Dallas, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450462
Location8200 Walnut Hill LaneDallas, TX 75231 · Dallas County
Emergency services Birthing friendly

North Central Surgical Center LLP

Acute Care Hospitals · Dallas, TX
OwnershipVoluntary non-profit - Other
CMS Certification Number670049
Location9301 North Central Expressway Suite 100Dallas, TX 75231 · Dallas County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75231 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
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.

89.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.85
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
95%626 patients5/55-star benchmark: 85%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
89%194 patients3/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%752 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
73%1,195 patients4/55-star benchmark: 97%
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…
94%1,014 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
93%1,195 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
26%1,195 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
53%1,195 patients
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 5

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

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
4 suppliers15 claims700 services$4.72 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
4 suppliers16 claims730 services$8.47 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
5 suppliers30 claims1,510 services$3.47 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
4 suppliers11 claims1,330 services$0.23 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
5 suppliers14 claims1,095 services$0.23 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

RONALD J CHALK D.D.S.
Dentist (General Practice)
8315 WALNUT HILL LN, SUITE 230
DALLAS, TX 75231
Dallas County (214) 691-6698
DR. CHARLES WESLEY BRADLEY DDS
Dentist (General Practice)
8315 WALNUT HILL LN, SUITE 200
DALLAS, TX 75231
Dallas County (214) 378-7930
BRYAN PRUITT MD
Plastic Surgery
8315 WALNUT HILL LN, SUITE 125
DALLAS, TX 75231
Dallas County (214) 363-6000
SURGISTAR LP
Clinic/Center (Ambulatory Surgical)
8315 WALNUT HILL LN, STE 110
DALLAS, TX 75231
Dallas County (214) 363-9946
SMILE TEXAS OUTREACH, PC
Dentist
8315 WALNUT HILL LN, SUITE 230
DALLAS, TX 75231
Dallas County (888) 833-8441
KERRY ROBIN CARDER MD
Dermatology (Pediatric Dermatology)
8315 WALNUT HILL LN, SUITE 135
DALLAS, TX 75231
Dallas County (214) 580-1011
JEREMY NEWTON
Nurse Anesthetist, Certified Registered
8315 WALNUT HILL LN, SUITE 120
DALLAS, TX 75231
Dallas County (214) 363-9946
FERTILITY SPECIALISTS OF DALLAS, PA
Specialist
8315 WALNUT HILL LN, STE. 225
DALLAS, TX 75231
Dallas County (214) 750-5500

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 J. Marcus Downs's NPI number?

The NPI number for J. Marcus Downs is 1811922610. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is J. Marcus Downs located?

J. Marcus Downs practices at 8315 Walnut Hill Ln Suite 220, Dallas, TX 75231. The listed phone number is (214) 363-6123.

What is J. Marcus Downs's specialty?

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

Is J. Marcus Downs enrolled in Medicare?

Yes. J. Marcus Downs 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 J. Marcus Downs accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 8 other insurers list J. Marcus Downs 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 J. Marcus Downs affiliated with any hospitals?

According to CMS data, J. Marcus Downs is affiliated with Texas Health Presbyterian Hospital Dallas and North Central Surgical Center LLP.

When was this NPI record last updated?

The NPPES record for J. Marcus Downs was last updated on March 30, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.