JAMES C. WEIS MD
NPI 1922090893
Orthopaedic Surgery in Allentown, PA


Quality Rating: 87.41 out of 100 score

NPI Status: Active since August 17, 2005

Contact Information

250 CETRONIA ROAD
SUITE 303
ALLENTOWN, PA
ZIP 18104
Phone: (610) 973-6200
Fax: (610) 973-6546

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  • Individual
  • Male
  • Orthopaedic Surgery
  • PECOS Enrolled
  • Medicare Quality Reporting

About JAMES WEIS

This page provides the complete NPI Profile along with additional information for James Weis, a provider established in Allentown, Pennsylvania with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1922090893 assigned on August 2005. The practitioner's primary taxonomy code is 207X00000X with license number MD031627E (PA). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1922090893
Provider Name
JAMES C. WEIS MD
Gender
Male
Entity Type
Individual
Location Address
250 CETRONIA ROAD SUITE 303 ALLENTOWN, PA 18104
Location Phone
(610) 973-6200
Location Fax
(610) 973-6546
Mailing Address
PO BOX 848269 BOSTON, MA 02284
Mailing Phone
(610) 973-1700
Mailing Fax
(610) 973-6546
Is Sole Proprietor?
No
Enumeration Date
08-17-2005
Last Update Date
01-16-2014
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD031627E
License State
PA
Taxonomy Description
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207XS0117XAllopathic & Osteopathic Physicians

Orthopaedic Surgery
Orthopaedic Surgery of the Spine

MD031627E (PA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
117745OTHER (01)PABLUE SHIELD
C30611MEDICARE UPIN (02)PA 
0010618420001MEDICAID (05)PA 
0066208000OTHER (01)PAKEYSTONE EAST
4515759OTHER (01)PAAETNA
6891202001OTHER (01)PACIGNA
117745OTHER (01)PAKEYSTONE HEALTH PLAN CENT
117745OTHER (01)PAAMERIHEALTH ADMINISTRATOR
200023704OTHER (01)PARAILROAD MEDICARE
821058OTHER (01)FIRST PRIORITY HEALTH
P592790OTHER (01)PAOXFORD
01235401OTHER (01)PACAPITAL BLUE CROSS
21890OTHER (01)PAGEISINGER
117745MEDICARE PIN (08)PA 

Medicare Participation & PECOS Enrollment Status

James Weis is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Neuromuscular stimulator, electronic shock unit (HCPCS:E0745)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE000N)

    Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible (HCPCS:E0849)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

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

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.

This service was performed 20 times for 17 patients

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

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.

This service was performed 100 times for 78 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 110 times for 102 patients

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

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.

This service was performed 30 times for 29 patients

Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc

This procedure involves the fusion of a lower spine bone and the partial removal of a spine bone or disc from the back. It's done to relieve pain or correct a deformity. One disc is involved in this procedure. Recovery time varies based on individual health.

This service was performed 28 times for 27 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

This service was performed 33 times for 28 patients

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

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.

This service was performed 100 times for 100 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 15 times for 15 patients

Partial removal of spine bone with re-exploration, release of lower spinal cord or nerves and/or removal of disc, 1 interspace

This procedure involves the partial removal of a spine bone to alleviate pressure on the spinal cord or nerves. It may also involve removing a disc from one interspace. A re-exploration is done to ensure the success of the procedure and the relief of symptoms.

This service was performed 11 times for 11 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 45 times for 44 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

This service was performed 26 times for 20 patients

Placement of stabilizing device to back of 1 spine bone in neck

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

This service was performed 23 times for 23 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 109 times for 74 patients

X-ray of lower and sacral spine, minimum of 4 views

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

This service was performed 22 times for 22 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 32 times for 17 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 18104 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.88
  • Minimum New Patient Price $54.64
  • Maximum New Patient Price $166.87
  • Average New Patient Copayment $21.22
  • Minimum New Patient Copayment $13.66
  • Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.36
  • Minimum Established Patient Price $17.33
  • Maximum Established Patient Price $135.84
  • Average Established Patient Copayment $17.09
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $33.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 87.41, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: .

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 87.41 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 77.12

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Advance Care Plan 96% 226
Breast Cancer Screening 64% 132
Closing the Referral Loop: Receipt of Specialist Report 39% 106
Controlling High Blood Pressure 66% 35
Documentation of Current Medications in the Medical Record 97% 602
Falls: Screening for Future Fall Risk 91% 222
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 89% 438
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 14% 502
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 95% 315
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 68% 22
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 97% 315
Provide Patients Electronic Access to Their Health Information 91% 204
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease 77% 31

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1922090893, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
2
Doubled → 4
Pos 4
2
Unchanged
Pos 5
0
Doubled → 0
Pos 6
9
Unchanged
Pos 7
0
Doubled → 0
Pos 8
8
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 4 + 2 + 0 + 9 + 0 + 8 + 1 + 8 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1922090893.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Orthopaedic Surgery
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Orthopaedic Surgery
250 CETRONIA ROAD, SUITE 100
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physician Assistant
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physician Assistant
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physician Assistant
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Occupational Therapist (Hand)
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Occupational Therapist (Hand)
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Anesthesiology (Pain Medicine)
250 CETRONIA ROAD
ALLENTOWN, PA 18104
Surgery
250 CETRONIA ROAD, SUITE 302
ALLENTOWN, PA 18104
Occupational Therapist (Hand)
250 CETRONIA ROAD, SUITE303
ALLENTOWN, PA 18104
Clinic/Center (Radiology, Mammography)
250 CETRONIA ROAD, SUITE 102
ALLENTOWN, PA 18104
Chiropractor
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Physical Therapist
250 CETRONIA ROAD, SUITE 303
ALLENTOWN, PA 18104
Specialist/Technologist (Athletic Trainer)
250 CETRONIA ROAD
ALLENTOWN, PA 18104
Clinic/Center (Radiology)
250 CETRONIA ROAD, SUITE 101
ALLENTOWN, PA 18104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922090893, enumerated as an "individual" on August 17, 2005.

The provider is located at 250 CETRONIA ROAD SUITE 303 ALLENTOWN, PA 18104 and the phone number is (610) 973-6200.

Orthopaedic Surgery with taxonomy code 207X00000X.

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare, Medicaid, Aetna,. Please consult your insurance carrier or call the provider to verify.