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DR. JAMES M LOPES MD
NPI 1861659476
Surgery in West Orange, NJ

Active since May 21, 2008PECOS EnrolledAccepts Medicare Assignment
375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 07052(973) 731-7707(973) 232-2301 Get Directions Write a Review

NPPES record last updated: May 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James M Lopes Md NPPES

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

DR. JAMES M LOPES MD (NPI 1861659476) is an individual surgery provider in West Orange, New Jersey, licensed in New Jersey (25MA08930100) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Overlook Medical Center, and is a graduate of Albert Einstein College Of Medicine Of Yeshiva University (2004).

NPPES Registry Identity

NPI1861659476
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. JAMES M LOPESCredential: MD
Location Address375 MOUNT PLEASANT AVEWest Orange, NJ 07052-2750
Mailing Address375 Mount Pleasant AveWest Orange, NJ 07052-2750 · (973) 731-7707 · Fax (973) 232-2301
Phone(973) 731-7707
Fax(973) 232-2301
Sole ProprietorNo
Medical School CMSAlbert Einstein College Of Medicine Of Yeshiva UniversityGraduated 2004
Enumeration DateMay 21, 2008
Last NPPES UpdateMay 15, 2020
NPPES CertifiedMay 15, 2020
✔ NPI 1861659476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in NJ · 25MA08930100
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
375 MOUNT PLEASANT AVE, West Orange, NJ 07052
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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

Dr. James M Lopes 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 ID941341846
PECOS Enrollment IDI20111017000055
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 12

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 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.
109 services109 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.
50 services44 patients
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.
43 services25 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.
37 services35 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.
36 services30 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
31 services31 patients

Hospital Affiliations CMS Care Compare

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

Overlook Medical Center

Acute Care Hospitals · Summit, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310051
Location99 Beauvoir AvenueSummit, NJ 07901 · Union County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07052 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
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.

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
93%427 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
28%539 patients2/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
88%539 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 certified EHR technology to the patient (or the patient-authorized representative), or in…
1%539 patients1/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
1%515 patients1/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
9%539 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 2

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
2 suppliers13 claims360 services$4.90 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
2 suppliers12 claims635 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 20

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

YESICA CANO APN
Nurse Practitioner (Gerontology)
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-9442
DR. JOAO A LOPES M.D.
Surgery
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-7707
ADILA ASIM FAKHAR RD
Dietitian, Registered
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-9442
MR. STEPHEN CRANE MD
Obstetrics & Gynecology
375 MOUNT PLEASANT AVE, SUITE 202
WEST ORANGE, NJ 07052
Essex County (973) 731-7707
DR. DAVID P DOBESH MD
Internal Medicine (Clinical Cardiac Electrophysiology)
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-9442
ELIZABETH ANN JEHLE CPNP-PC
Nurse Practitioner (Pediatrics)
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 322-6900
PATRICIA ANN CORTINA PT
Physical Therapist
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (908) 322-6363
DR. DANIEL SANSOBRINO MD
Obstetrics & Gynecology
375 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052
Essex County (973) 731-7707

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 Lopes's NPI number?

The NPI number for James Lopes is 1861659476. It was assigned to this individual provider in the NPPES registry on May 21, 2008.

Where is James Lopes located?

James Lopes practices at 375 Mount Pleasant Ave, West Orange, NJ 07052. The listed phone number is (973) 731-7707.

What is James Lopes's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is James Lopes enrolled in Medicare?

Yes. James Lopes 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.

Is James Lopes affiliated with any hospitals?

According to CMS data, James Lopes is affiliated with Overlook Medical Center.

When was this NPI record last updated?

The NPPES record for James Lopes was last updated on May 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.