1. Home
  2. Directory
  3. Ohio
  4. Cincinnati
  5. Obstetrics Gynecology
  6. NPI Profile

JAMES C PAVELKA M.D.
NPI 1861521460
Obstetrics & Gynecology - Gynecologic Oncology in Cincinnati, OH

Active since March 02, 2007PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
3219 CLIFTON AVE, SUITE 100, CINCINNATI, OH 45220(513) 862-1888(513) 862-3616 Get Directions Write a Review

NPPES record last updated: March 30, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About James C Pavelka M.d. NPPES

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

JAMES C PAVELKA M.D. (NPI 1861521460) is an individual gynecologic oncology provider in Cincinnati, Ohio, licensed in Ohio (35-092322) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Ft Thomas, and is a graduate of Ohio State University College Of Medicine (2001).

NPPES Registry Identity

NPI1861521460
Entity TypeIndividualMale
Primary Taxonomy207VX0201X
Provider Legal NameJAMES C PAVELKACredential: M.D.
Location Address3219 CLIFTON AVE, SUITE 100Cincinnati, OH 45220-3027
Mailing AddressPo Box 635063Cincinnati, OH 45263-5063 · (513) 569-2043 · Fax (513) 569-5199
Phone(513) 862-1888
Fax(513) 862-3616
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2001
Enumeration DateMarch 2, 2007
Last NPPES UpdateMarch 30, 2010
✔ NPI 1861521460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
Licenses✔ Licensed in OH · 35-092322✔ Licensed in CA · A92102
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
Also ListedSpecialistTaxonomy 174400000X · License 24369 (KY)
3219 CLIFTON AVE, Cincinnati, OH 45220
Open in Google Maps ↗

Other Identifiers 4

Medicaid7900073650KY
Medicare PIN0969464KY
Medicaid2905824OH
Medicare PIN4247561OH

Accepted Insurance

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

James C Pavelka 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 ID7113086240
PECOS Enrollment IDI20081105000001, I20090204000000
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 6

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.

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.
48 services23 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.
42 services14 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.
34 services27 patients
Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less 58571
This procedure involves the removal of certain internal structures through small incisions in the abdomen, using a special tool called an endoscope. It's performed when these structures are causing health issues. The weight reference (250.0 g or less) relates to the size of the structures being removed.
22 services22 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.
14 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

Good Samaritan Hospital

Acute Care Hospitals · Cincinnati, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360134
Location375 Dixmyth AvenueCincinnati, OH 45220 · Hamilton County
Emergency services Birthing friendly

Bethesda North

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360179
Location10500 Montgomery RoadCincinnati, OH 45242 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45220 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
2%42 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
64%25 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
86%44 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…
24%58 patients1/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 20

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

HELEN K KOSELKA M.D.
Internal Medicine
3219 CLIFTON AVE, SUITE 100
CINCINNATI, OH 45220
Hamilton County (513) 528-5600
HELMUT F SCHELLHAS MD
Obstetrics & Gynecology (Gynecologic Oncology)
3219 CLIFTON AVE, SUITE 100
CINCINNATI, OH 45220
Hamilton County (513) 862-1888
FOR WOMEN INC
Obstetrics & Gynecology
3219 CLIFTON AVE, SUITE 125
CINCINNATI, OH 45220
Hamilton County (513) 563-2030
JACK B BASIL MD
Obstetrics & Gynecology (Gynecologic Oncology)
3219 CLIFTON AVE, SUITE 100
CINCINNATI, OH 45220
Hamilton County (513) 862-1888
DR. KENNETH J NEWMARK M.D.
Internal Medicine (Nephrology)
3219 CLIFTON AVE, #325
CINCINNATI, OH 45220
Hamilton County (513) 861-0800
DR. ROBERT K HUTCHINS MD
Ophthalmology
3219 CLIFTON AVE, SUITE 210
CINCINNATI, OH 45220
Hamilton County (513) 861-7575
DR. AMIR IZHAR M.D.
Internal Medicine (Nephrology)
3219 CLIFTON AVE, #325
CINCINNATI, OH 45220
Hamilton County (513) 861-0800
SAMARITAN OB GYN INC
Obstetrics & Gynecology
3219 CLIFTON AVE, SUITE 230
CINCINNATI, OH 45220
Hamilton County (513) 559-9411

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 Pavelka's NPI number?

The NPI number for James Pavelka is 1861521460. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Where is James Pavelka located?

James Pavelka practices at 3219 Clifton Ave Suite 100, Cincinnati, OH 45220. The listed phone number is (513) 862-1888.

What is James Pavelka's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

Is James Pavelka enrolled in Medicare?

Yes. James Pavelka 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 Pavelka accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 2 other insurers list James Pavelka 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 Pavelka affiliated with any hospitals?

According to CMS data, James Pavelka is affiliated with St Elizabeth Ft Thomas, St Elizabeth Edgewood, St Elizabeth Florence, Good Samaritan Hospital and Bethesda North.

When was this NPI record last updated?

The NPPES record for James Pavelka was last updated on March 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.