JAMES EDWARD PILKINGTON MD
NPI 1871913905
Urology in Lake Wales, FL

Q: What is James Pilkington's NPI number?

The NPI number for James Pilkington is 1871913905. It was assigned to this individual provider in the NPPES registry on April 16, 2014.

Q: What is James Pilkington's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for James Pilkington was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 16, 2014PECOS EnrolledAccepts Medicare Assignment

407 S 11TH ST, LAKE WALES, FL 33853(863) 679-2707(863) 676-3621 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 22, 2021, Sep 26, 2019, Aug 11, 2019 (3 updates tracked since 2019).

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About James Edward Pilkington Md NPPES

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

JAMES EDWARD PILKINGTON MD (NPI 1871913905) is an individual urology provider in Lake Wales, Florida, licensed in Florida (ME139761) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1871913905

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameJAMES EDWARD PILKINGTONCredential: MD

Location Address407 S 11TH STLake Wales, FL 33853-4243

Mailing Address407 S 11th StLake Wales, FL 33853-4243 · (863) 679-2707

Phone(863) 679-2707

Fax(863) 676-3621

Sole ProprietorYes

Medical School CMSOtherGraduated 2014

Enumeration DateApril 16, 2014

Last NPPES UpdateDecember 22, 20213 updates tracked since enumeration

NPPES CertifiedDecember 22, 2021

✔ NPI 1871913905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in FL · ME139761

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

407 S 11TH ST, Lake Wales, FL 33853

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Secondary Practice Locations 2

Location 11501 Kings HwyShreveport, LA 71103-4228 · Phone (318) 675-6111

Location 2350 1st St NWinter Haven, FL 33881-4113 · Phone (863) 679-2707

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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

James Edward Pilkington 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 ID4880921618

PECOS Enrollment IDI20190815003642

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

Medicare enrollment records show James Pilkington reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bond Clinic PA

13 mi

Internal Medicine

500 E CENTRAL AVE
Winter Haven, FL 33880

Reassigned Medicare billing, Florida enrollment
120 clinicians in this Medicare group

NPI 1881639193 (863) 293-1191

Florida Hospital Medical Group Inc

46 mi

Family Medicine

1115 E RIDGEWOOD ST
Orlando, FL 32803

Reassigned Medicare billing, Florida enrollment
3,005 clinicians in this Medicare group

NPI 1225034234 (407) 841-1100

Florida Hospital Physician Group Inc

54 mi

Family Medicine

3000 MEDICAL PARK DR, STE 320
Tampa, FL 33613

Reassigned Medicare billing, Florida enrollment
1,719 clinicians in this Medicare group

NPI 1174955256 (813) 336-5766

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 22

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 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.

668 services450 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.

296 services225 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

171 services123 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

167 services142 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

156 services115 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.

66 services66 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

60 services33 patients

Simple change of bladder tube 51705

A simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.

46 services12 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

44 services39 patients

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.

42 services42 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

39 services33 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

36 services34 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

32 services32 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

28 services28 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

25 services25 patients

Insertion of device into abdomen with pressure and urine flow rate study 51797

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

24 services24 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

23 services23 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

22 services22 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

20 services20 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

20 services15 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

19 services15 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

17 services16 patients

Hospital Affiliations CMS Care Compare 4

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

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100007

Location601 E Rollins StOrlando, FL 32803 · Orange County

Emergency services Birthing friendly

Adventhealth Lake Wales

Acute Care Hospitals · Lake Wales, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100099

Location410 S 11th StLake Wales, FL 33853 · Polk County

Emergency services

Adventhealth Sebring

Acute Care Hospitals · Sebring, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100109

Location4200 Sun N Lake BlvdSebring, FL 33872 · Highlands County

Emergency services Birthing friendly

Adventhealth Heart Of Florida

Acute Care Hospitals · Davenport, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100137

Location40100 Hwy 27Davenport, FL 33837 · Polk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33853 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

2 suppliers50 claims6,225 services$0.11 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

6 suppliers62 claims6,675 services$1.66 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

3 suppliers47 claims6,330 services$5.21 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 4

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

MORGAN BRIANNA KIDWELL PA

Physician Assistant

407 S 11TH ST
LAKE WALES, FL 33853

Polk County (863) 419-8366

DR. BUCK ANDREU SCOTT M.D.

Surgery

407 S 11TH ST
LAKE WALES, FL 33853

Polk County (863) 679-2707

FLORIDA HOSPITAL PHYSICIAN GROUP INC

Urology

407 S 11TH ST
LAKE WALES, FL 33853

Polk County (863) 419-8366

CHESTER C WILMOT M.D.

Urology

407 S 11TH ST
LAKE WALES, FL 33853

Polk County (863) 419-8366

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 Pilkington's NPI number?

The NPI number for James Pilkington is 1871913905. It was assigned to this individual provider in the NPPES registry on April 16, 2014.

Where is James Pilkington located?

James Pilkington practices at 407 S 11th St, Lake Wales, FL 33853. The listed phone number is (863) 679-2707.

What is James Pilkington's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is James Pilkington enrolled in Medicare?

Yes. James Pilkington 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 Pilkington's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Pilkington reassigns Medicare benefits to 3 organizations: Bond Clinic PA (Winter Haven, FL), Florida Hospital Medical Group Inc (Orlando, FL) and Florida Hospital Physician Group Inc (Tampa, FL). 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 Pilkington's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Pilkington accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 4 other insurers list James Pilkington 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 Pilkington affiliated with any hospitals?

According to CMS data, James Pilkington is affiliated with Adventhealth Orlando, Adventhealth Lake Wales, Adventhealth Sebring and Adventhealth Heart Of Florida.

When was this NPI record last updated?

The NPPES record for James Pilkington was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.