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DR. JAMES AUTERI FERGUSON M.D., MPH, CPH
NPI 1831553320
Hospitalist in East Islip, NY

Active since April 11, 2016PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
170 W MAIN ST, EAST ISLIP, NY 11730(631) 581-2049(631) 581-3354 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 3, 2025, Sep 5, 2019, Feb 28, 2018 and 3 more (6 updates tracked since 2016).

About Dr. James Auteri Ferguson M.d., Mph, Cph NPPES

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

DR. JAMES AUTERI FERGUSON M.D., MPH, CPH (NPI 1831553320) is an individual hospitalist provider in East Islip, New York, licensed in New York (301034) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Albany Medical Center Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1831553320
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. JAMES AUTERI FERGUSONCredential: M.D., MPH, CPH
Location Address170 W MAIN STEast Islip, NY 11730
Mailing Address170 W Main StEast Islip, NY 11730-2216 · (631) 581-2049 · Fax (631) 581-3354
Phone(631) 581-2049
Fax(631) 581-3354
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 11, 2016
Last NPPES UpdateNovember 3, 20256 updates tracked since enumeration
NPPES CertifiedNovember 3, 2025
✔ NPI 1831553320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in NY · 301034
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 57.028733 (OH), MD25033 (ME), 301034 (NY)
170 W MAIN ST, East Islip, NY 11730
Open in Google Maps ↗

Secondary Practice Locations 2

Location 111100 Euclid Ave, Bolwell Suite 1200Cleveland, OH 44106-1716 · Phone (216) 844-3944 · Fax (216) 844-8591
Location 2221 Jericho TpkeSyosset, NY 11791-4515 · Phone (516) 496-6400

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Insurance Corporation of Ohio, Taro Health.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

Dr. James Auteri Ferguson M.d., Mph, Cph 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 ID9234413964
PECOS Enrollment IDI20191016001818, I20210614002744
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

9

Medicare enrollment records show James Ferguson reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Provider Profile
0.9 mi
Family Medicine
170 W MAIN ST
East Islip, NY 11730
  • Reassigned Medicare billing, New York enrollment
NPI 1730183013 (631) 581-2049
Southwest Suffolk, P.C
9.6 mi
Family Medicine
48 ROUTE 25A, SUITE 210
Smithtown, NY 11787
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Southwest Suffolk Medical PC
  • 348 clinicians in this Medicare group
NPI 1730428467 (631) 465-6225
North Shore - Lij Medical PC
28 mi
Internal Medicine
270-05 76TH AVE
New Hyde Park, NY 11040
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1790043479 (516) 465-8089
Nes Medical Services Of New England Inc
360 mi
Emergency Medicine
360 BROADWAY
Bangor, ME 04401
  • Reassigned Medicare billing, Maine enrollment
  • 54 clinicians in this Medicare group
NPI 1396401907 (207) 907-3000
Eastern Maine Medical Center
360 mi
General Acute Care Hospital
489 STATE ST
Bangor, ME 04401
  • Reassigned Medicare billing, Maine enrollment
  • 788 clinicians in this Medicare group
NPI 1790789147 (207) 973-7000
University Hospitals Medical Group Inc
443 mi
Multi-Specialty
11100 EUCLID AVE
Cleveland, OH 44106
  • Reassigned Medicare billing, Ohio enrollment
  • 3,958 clinicians in this Medicare group
NPI 1669499414 (216) 844-1000
Ohiohealth Corporation
512 mi
Thoracic Surgery (Cardiothoracic Vascular Surgery)
85 MCNAUGHTEN RD STE 110
Columbus, OH 43213
  • Reassigned Medicare billing, Ohio enrollment
  • 3,314 clinicians in this Medicare group
NPI 1265627301 (614) 856-9100
Hospitalist Medicine Physicians Of Ohio, Professional Corporation
512 mi
Internal Medicine
6001 E BROAD ST
Columbus, OH 43213
  • Reassigned Medicare billing, Ohio enrollment
  • 776 clinicians in this Medicare group
NPI 1043572290 (614) 234-7535
Apogee Medical Group, New York, PC
2,175 mi
Internal Medicine
15059 N SCOTTSDALE ROAD, SUITE 600
Scottsdale, AZ 85254
  • Reassigned Medicare billing, New York enrollment
  • 354 clinicians in this Medicare group
NPI 1841520236 (602) 778-3600

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
274 services118 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.
113 services58 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
83 services83 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
71 services70 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
60 services60 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
59 services58 patients

Hospital Affiliations CMS Care Compare 5

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

Albany Medical Center Hospital

Acute Care Hospitals · Albany, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330013
Location43 New Scotland Avenue, Mail Code 34Albany, NY 12208 · Albany County
Emergency services Birthing friendly

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330106
Location300 Community DriveManhasset, NY 11030 · Nassau County
Emergency services Birthing friendly

Good Samaritan Hospital Medical Center

Acute Care Hospitals · West Islip, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330286
Location1000 Montauk HighwayWest Islip, NY 11795 · Suffolk County
Emergency services Birthing friendly

Lake Health

Acute Care Hospitals · Concord, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360098
Location7590 Auburn RoadConcord, OH 44077 · Lake County
Emergency services

University Hospitals - Elyria Medical Center

Acute Care Hospitals · Elyria, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360145
Location630 East River StreetElyria, OH 44035 · Lorain County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11730 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

JAMES W FERGUSON MD LLC
Clinic/Center (Primary Care)
170 W MAIN ST
EAST ISLIP, NY 11730
Suffolk County (631) 581-2049
JAMES W FERGUSON MD
Family Medicine
170 W MAIN ST
EAST ISLIP, NY 11730
Suffolk County (631) 581-2049

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 Ferguson's NPI number?

The NPI number for James Ferguson is 1831553320. It was assigned to this individual provider in the NPPES registry on April 11, 2016.

Where is James Ferguson located?

James Ferguson practices at 170 W Main St, East Islip, NY 11730. The listed phone number is (631) 581-2049.

What is James Ferguson's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is James Ferguson enrolled in Medicare?

Yes. James Ferguson 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 Ferguson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Ferguson reassigns Medicare benefits to 9 organizations: (East Islip, NY), Southwest Suffolk, P.C (Smithtown, NY), North Shore - Lij Medical PC (New Hyde Park, NY), Nes Medical Services Of New England Inc (Bangor, ME), Eastern Maine Medical Center (Bangor, ME) and 4 more organizations, listed in the Medicare section above. 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 Ferguson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Ferguson accept?

Health plans from CareSource, Oscar Insurance Corporation of Ohio and Taro Health list James Ferguson 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 Ferguson affiliated with any hospitals?

According to CMS data, James Ferguson is affiliated with Albany Medical Center Hospital, North Shore University Hospital, Good Samaritan Hospital Medical Center, Lake Health and University Hospitals - Elyria Medical Center.

When was this NPI record last updated?

The NPPES record for James Ferguson was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.