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JAMES RICHARD CLEMENS MD
NPI 1871519900
Otolaryngology in Green Bay, WI

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1821 S WEBSTER AVE, GREEN BAY, WI 54301(920) 496-4700(920) 436-1332 Get Directions Write a Review

NPPES record last updated: December 6, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About James Richard Clemens Md NPPES

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

JAMES RICHARD CLEMENS MD (NPI 1871519900) is an individual otolaryngology provider in Green Bay, Wisconsin, licensed in Wisconsin (38955) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with St Nicholas Hospital, and is a graduate of University Of Cincinnati College Of Medicine (1990).

NPPES Registry Identity

NPI1871519900
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameJAMES RICHARD CLEMENSCredential: MD
Location Address1821 S WEBSTER AVEGreen Bay, WI 54301-2253
Mailing Address1821 S Webster AveGreen Bay, WI 54301-2253 · (920) 496-4700
Phone(920) 496-4700
Fax(920) 436-1332
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1990
Enumeration DateJuly 14, 2006
Last NPPES UpdateDecember 6, 2018
✔ NPI 1871519900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in WI · 38955
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1821 S WEBSTER AVE, Green Bay, WI 54301
Open in Google Maps ↗

Other Identifiers 1

Medicaid32338300WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Security Health Plan.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 Richard Clemens 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 ID8628114782
PECOS Enrollment IDI20091005000343
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.

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.
88 services88 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.
78 services68 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
51 services40 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.
33 services27 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.
32 services32 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
27 services25 patients

Hospital Affiliations CMS Care Compare 3

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

IRMA CATHERINE SMET PHD
Psychologist
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
SERENA ASHOUR APNP
Nurse Practitioner
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
KATHLEEN MARIE BARKOW MD
Pediatrics
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
GEORGE E WHETMORE DO
Pediatrics
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
LAUREN M RESCH NP
Nurse Practitioner
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
DR. ESRA SIDDEEK DO
Neuromusculoskeletal Medicine & OMM
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
KELSEY SMITH DPT
Physical Therapist
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700
CARRIE ANN THOMS MD
Surgery
1821 S WEBSTER AVE
GREEN BAY, WI 54301
Brown County (920) 496-4700

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 Clemens's NPI number?

The NPI number for James Clemens is 1871519900. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Where is James Clemens located?

James Clemens practices at 1821 S Webster Ave, Green Bay, WI 54301. The listed phone number is (920) 496-4700.

What is James Clemens's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James Clemens enrolled in Medicare?

Yes. James Clemens 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 Clemens accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Security Health Plan list James Clemens 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 Clemens affiliated with any hospitals?

According to CMS data, James Clemens is affiliated with St Nicholas Hospital, St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for James Clemens was last updated on December 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.