HEATHER R JAMES P.A.-C
NPI 1922114347
Physician Assistant in Sheboygan, WI

Active since August 21, 2006PECOS EnrolledAccepts Medicare Assignment
3400 UNION AVE, SHEBOYGAN, WI 53081(920) 828-2700(920) 828-2905 Get Directions Write a Review

NPPES record last updated: December 2, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 2, 2024, Dec 6, 2021, Apr 29, 2019 (3 updates tracked since 2019).

About Heather R James P.a.-c NPPES

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

HEATHER R JAMES P.A.-C (NPI 1922114347) is an individual physician assistant in Sheboygan, Wisconsin, licensed in Wisconsin (1822) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Aurora Health Care Central Inc, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1922114347
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameHEATHER R JAMESCredential: P.A.-C
Location Address3400 UNION AVESheboygan, WI 53081-8426
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Fax(920) 828-2905
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateAugust 21, 2006
Last NPPES UpdateDecember 2, 20243 updates tracked since enumeration
NPPES CertifiedDecember 2, 2024
NPI 1922114347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in WI · 1822
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3400 UNION AVE, Sheboygan, WI 53081

Other Identifiers 3

Other14825WI · Network Health
OtherP00192602WI · Medicare Railroad
Medicaid41998200WI

Accepted 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

Heather R James P.a.-c 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 ID9739138975
PECOS Enrollment IDI20050114000453
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 2

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 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.
263 services239 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
55 services37 patients

Hospital Affiliations CMS Care Compare

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

Aurora Health Care Central Inc

Acute Care Hospitals · Sheboygan, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520035
Location3400 Union AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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.

Referred Medical Equipment & Supplies CMS DME claims

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

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606
DME-Other DME · category DE013N
1 supplier15 claims15 services$2,024.39 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 20

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

Radiology (Diagnostic Radiology)
3400 UNION AVE
SHEBOYGAN, WI 53081
Specialist/Technologist (Athletic Trainer)
3400 UNION AVE
SHEBOYGAN, WI 53081
Nurse Anesthetist, Certified Registered
3400 UNION AVE
SHEBOYGAN, WI 53081
Internal Medicine (Pulmonary Disease)
3400 UNION AVE
SHEBOYGAN, WI 53081
Nurse Practitioner
3400 UNION AVE
SHEBOYGAN, WI 53081
Hospitalist
3400 UNION AVE
SHEBOYGAN, WI 53081
Obstetrics & Gynecology
3400 UNION AVE
SHEBOYGAN, WI 53081
Hospitalist
3400 UNION AVE
SHEBOYGAN, WI 53081

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 Heather James's NPI number?

The NPI number for Heather James is 1922114347. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Heather James located?

Heather James practices at 3400 Union Ave, Sheboygan, WI 53081. The listed phone number is (920) 828-2700.

What is Heather James's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Heather James enrolled in Medicare?

Yes. Heather 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 Heather James accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), Quartz and UnitedHealthcare list Heather 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 Heather James affiliated with any hospitals?

According to CMS data, Heather James is affiliated with Aurora Health Care Central Inc.

When was this NPI record last updated?

The NPPES record for Heather James was last updated on December 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.