DR. JAMES THOMAS BILBO MD
NPI 1841295656
Orthopaedic Surgery in Highland Heights, KY

Q: What is James Bilbo's NPI number?

The NPI number for James Bilbo is 1841295656. It was assigned to this individual provider in the NPPES registry on June 17, 2005.

Q: What is James Bilbo's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for James Bilbo was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 17, 2005PECOS Enrolled

90.38/100

CMS Quality Rating

2626 ALEXANDRIA PIKE STE 100, HIGHLAND HEIGHTS, KY 41076(859) 301-2663(859) 817-7848 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 8, 2021, Feb 3, 2016 (2 updates tracked since 2016).

On this page

About Dr. James Thomas Bilbo Md NPPES

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

DR. JAMES THOMAS BILBO MD (NPI 1841295656) is an individual orthopaedic surgery provider in Highland Heights, Kentucky, licensed in Kentucky (24525) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Edgewood.

NPPES Registry Identity

NPI1841295656

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. JAMES THOMAS BILBOCredential: MD

Location Address2626 ALEXANDRIA PIKE STE 100Highland Heights, KY 41076-1530

Mailing Address560 S Loop RdEdgewood, KY 41017-3405 · (859) 301-2663 · Fax (859) 301-0655

Phone(859) 301-2663

Fax(859) 817-7848

Sole ProprietorNo

Enumeration DateJune 17, 2005

Last NPPES UpdateJuly 8, 20212 updates tracked since enumeration

NPPES CertifiedJuly 8, 2021

✔ NPI 1841295656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in KY · 24525

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License 24525 (KY)

2626 ALEXANDRIA PIKE STE 100, Highland Heights, KY 41076

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Secondary Practice Location 1

Location 1560 S Loop RdEdgewood, KY 41017-3405 · Phone (859) 301-2663 · Fax (859) 817-7848

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.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. James Thomas Bilbo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41076 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

90.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.76

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

80%115 patients4/55-star benchmark: 100%

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…

99%140 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

99%67 patients5/55-star benchmark: 98%

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

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

Knee orthosis, elastic with joints, prefabricated, off-the-shelf L1812

DME-Orthotic Devices · category DF011N

1 supplier12 claims12 services$52.07 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 11

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

DR. FOREST THOMAS HEIS MD

Orthopaedic Surgery