DR. JAMES GROVER EPSTEIN MD
NPI 1891918017
Internal Medicine in Middleburg Heights, OH

Q: What is James Epstein's NPI number?

The NPI number for James Epstein is 1891918017. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Q: What is James Epstein's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for James Epstein was last updated on May 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 10, 2007PECOS EnrolledAccepts Medicare Assignment

88.85/100

CMS Quality Rating

18660 BAGLEY RD STE 400B, MIDDLEBURG HEIGHTS, OH 44130(440) 239-8737(440) 239-7811 Get Directions Write a Review

NPPES record last updated: May 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Dr. James Grover Epstein Md NPPES

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

DR. JAMES GROVER EPSTEIN MD (NPI 1891918017) is an individual internal medicine provider in Middleburg Heights, Ohio, licensed in Ohio (35049225) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Southwest General Health Center, and is a graduate of Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University (1981).

NPPES Registry Identity

NPI1891918017

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. JAMES GROVER EPSTEINCredential: MD

Location Address18660 BAGLEY RD STE 400BMiddleburg Heights, OH 44130-8455

Mailing AddressPo Box 241217Mayfield Hts, OH 44124-8817 · (440) 239-8737 · Fax (440) 239-7811

Phone(440) 239-8737

Fax(440) 239-7811

Sole ProprietorNo

Medical School CMSClvlnd Clinic Lerner College Of Med Of Case Wstn Rsv UniversityGraduated 1981

Enumeration DateApril 10, 2007

Last NPPES UpdateMay 7, 2021

NPPES CertifiedMay 7, 2021

✔ NPI 1891918017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in OH · 35049225

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

18660 BAGLEY RD STE 400B, Middleburg Heights, OH 44130

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Other Identifiers 1

Other110232987OH · Railroad Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual.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

Dr. James Grover Epstein 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 ID1850430620

PECOS Enrollment IDI20091208000406

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D1000944

James G Epstein MD Inc · Middleburg Heights, OH

Expired · Jun 25, 2026

CLIA Number36D1000944

Laboratory TypePhysician Office

Certificate Effective DateJune 26, 2024

Certificate Expiration DateJune 25, 2026

Laboratory DirectorJames G. Epstein MD

Laboratory Phone(440) 239-8737

Laboratory LocationJames G Epstein MD Inc18660 Bagley Road Bldg 2 Suite 400, Middleburg Heights, OH 44130

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 13

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, 30-39 minutes 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.

316 services217 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

278 services278 patients

Established patient office or other outpatient visit, 20-29 minutes 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.

274 services194 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

124 services123 patients

Influenza vaccine, quadrivalent, 0.5 ml dosage 90688

The Influenza vaccine, quadrivalent, 0.5 ml dosage, is a flu shot to protect against four strains of the flu virus. It's given as a small injection, typically in the arm, to help your body build immunity and fight off potential flu infections.

82 services82 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

82 services82 patients

Established patient office or other outpatient visit, 40-54 minutes 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

45 services41 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

36 services36 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

29 services25 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

25 services24 patients

Transitional care management services for problem of moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

16 services15 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

15 services15 patients

New patient office or other outpatient visit, 45-59 minutes 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.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Southwest General Health Center

Acute Care Hospitals · Middleburg Heights, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360155

Location18697 Bagley RoadMiddleburg Heights, OH 44130 · Cuyahoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44130 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

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.

88.85/100

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

Individually scored

Quality

100

Improvement Activities

Cost

62.84

Reported Quality Measures

Breast Cancer Screening

64%237 patients3/55-star benchmark: 93%

Cervical Cancer Screening

0%99 patients1/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

0%489 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

77%653 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

76%582 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

0%179 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

89%179 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

59%3,028 patients2/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

1%818 patients1/55-star benchmark: 100%

HIV Screening

0%411 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

23%1,205 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

51%778 patients3/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

23%878 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 71% · 1,136 patients

Patients screened: 70% · 1,136 patients

92%79 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

65%518 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 3% · 851 patients

Patients totalRate: 7% · 851 patients

5%851 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

16 suppliers42 claims97 services$5.79 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

10 suppliers26 claims33 services$1.03 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers11 claims56 services$1.22 avg. paid by Medicare

Hospital bed, variable height, hi-lo, with any type side rails, with mattress E0255

DME-Hospital Beds · category DB000N

1 supplier12 claims12 services$37.26 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Epstein's NPI number?

The NPI number for James Epstein is 1891918017. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is James Epstein located?

James Epstein practices at 18660 Bagley Rd Ste 400B, Middleburg Heights, OH 44130. The listed phone number is (440) 239-8737.

What is James Epstein's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Epstein enrolled in Medicare?

Yes. James Epstein 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 Epstein accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and MedMutual list James Epstein 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 Epstein affiliated with any hospitals?

According to CMS data, James Epstein is affiliated with Southwest General Health Center.

When was this NPI record last updated?

The NPPES record for James Epstein was last updated on May 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.