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DR. MILTON JAMES M.D.
NPI 1912909227
Ophthalmology in Durham, NC

Active since June 01, 2005PECOS EnrolledAccepts Medicare Assignment
4102 N ROXBORO ST, DURHAM, NC 27704(919) 595-2000(919) 595-2182 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Milton James M.d. NPPES

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

DR. MILTON JAMES M.D. (NPI 1912909227) is an individual ophthalmology provider in Durham, North Carolina, licensed in Ohio (35077543) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and is a graduate of Hahnemann University College Of Medicine (1992).

NPPES Registry Identity

NPI1912909227
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. MILTON JAMESCredential: M.D.
Location Address4102 N ROXBORO STDurham, NC 27704-2122
Mailing Address4102 N Roxboro StDurham, NC 27704-2122 · (919) 595-2000 · Fax (919) 595-2182
Phone(919) 595-2000
Fax(919) 595-2182
Sole ProprietorNo
Medical School CMSHahnemann University College Of MedicineGraduated 1992
Enumeration DateJune 1, 2005
Last NPPES UpdateDecember 9, 2011
✔ NPI 1912909227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in OH · 35077543✔ Licensed in PA · MD069803L✔ Licensed in WV · 20115
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
4102 N ROXBORO ST, Durham, NC 27704
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Other Identifiers 15

Other0895377OH · Mcr #other Tax Id
Medicare UPING54503OH
Medicare PIN31548LXDPA
Medicaid6300115000WV
Medicaid0017726390004PA
Medicare PIN180038216OH
Medicare PIN0895375WV
Medicare PIN180038218OH
Medicare PIN180038217OH
Medicare PIN0895374OH
Medicare PIN0895373OH
OtherP00336309OH · Rrmcr # Other Tax Id
Medicaid2150630OH
Medicare PIN180038219PA
Medicare PIN0895371OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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

Dr. Milton James 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 ID6002807948
PECOS Enrollment IDI20100222000636
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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
769 services324 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
562 services62 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
438 services97 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.
257 services232 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.
243 services148 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
137 services137 patients

Hospital Affiliations CMS Care Compare 2

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

Duke University Hospital

Acute Care Hospitals · Durham, NC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number340030
Location2100 Erwin RdDurham, NC 27705 · Durham County
Emergency services Birthing friendly

North Carolina Specialty Hospital

Acute Care Hospitals · Durham, NC
OwnershipProprietary
CMS Certification Number340049
Location3916 Ben Franklin BoulevardDurham, NC 27704 · Durham County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27704 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
98%414 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
64%188 patients3/55-star benchmark: 99%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
86%260 patients4/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
99%259 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%2,535 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
81%201 patients2/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%211 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
80%1,540 patients4/55-star benchmark: 97%
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…
1%546 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 460 patients
95%460 patients4/55-star benchmark: 98%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
95%201 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
82%1,540 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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
5%1,540 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 888 patients
0%888 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
26%1,540 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.

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.

JEREMIAH RICHARD MARION III MD
Ophthalmology
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2106
KATHLEEN BALDRIDGE GORDON MD
Ophthalmology
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000
ANDREA ELIZABETH ENGEL AU.D.
Audiologist
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000
HAVAN LEIGH HARRIS MS, CCC-SLP
Speech-Language Pathologist
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000
DANIEL J SIMON MD
Ophthalmology
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000
DR. SARAH H HODGES M.D.
Otolaryngology
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000
PANKAJ GUPTA MD
Otolaryngology
4102 N ROXBORO ST, NORTH CAROLINA EYE EAR NOSE AND THROAT
DURHAM, NC 27704
Durham County (919) 595-2000
NORTH CAROLINA EYE EAR NOSE & THROAT PA
Ophthalmology
4102 N ROXBORO ST
DURHAM, NC 27704
Durham County (919) 595-2000

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 Milton James's NPI number?

The NPI number for Milton James is 1912909227. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Where is Milton James located?

Milton James practices at 4102 N Roxboro St, Durham, NC 27704. The listed phone number is (919) 595-2000.

What is Milton James's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Milton James enrolled in Medicare?

Yes. Milton James 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 Milton James accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Milton James 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 Milton James affiliated with any hospitals?

According to CMS data, Milton James is affiliated with Duke University Hospital and North Carolina Specialty Hospital.

When was this NPI record last updated?

The NPPES record for Milton James was last updated on December 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.