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DR. JAMES P SWEENEY MD
NPI 1932213014
Internal Medicine in Nipomo, CA

Active since August 18, 2006PECOS EnrolledAccepts Medicare Assignment
96.5/100
CMS Quality Rating
697 W TEFFT ST, NIPOMO, CA 93444(805) 929-2272(805) 929-1454 Get Directions Write a Review

NPPES record last updated: December 5, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 5, 2024, Jun 18, 2024, Nov 8, 2023 and 3 more (6 updates tracked since 2021).

About Dr. James P Sweeney Md NPPES

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

DR. JAMES P SWEENEY MD (NPI 1932213014) is an individual internal medicine provider in Nipomo, California, licensed in California (G49462) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Maria, and is a graduate of Georgetown University School Of Medicine (1981).

NPPES Registry Identity

NPI1932213014
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JAMES P SWEENEYCredential: MD
Location Address697 W TEFFT STNipomo, CA 93444-9190
Mailing Address697 W Tefft StNipomo, CA 93444-9190 · (805) 929-2272 · Fax (805) 929-1454
Phone(805) 929-2272
Fax(805) 929-1454
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 1981
Enumeration DateAugust 18, 2006
Last NPPES UpdateDecember 5, 20246 updates tracked since enumeration
NPPES CertifiedDecember 5, 2024
✔ NPI 1932213014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G49462
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.
697 W TEFFT ST, Nipomo, CA 93444
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Secondary Practice Location 1

Location 12271 S Depot StSanta Maria, CA 93455-1216 · Phone (805) 349-8514 · Fax (805) 349-8958

Other Identifiers 2

Medicaid00G494621CA
OtherGB050ZCA · Medicare Id

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

Dr. James P Sweeney 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 ID8022190362
PECOS Enrollment IDI20080125000429
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 Reassignment

Medicare enrollment records show James Sweeney reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pacific Central Coast Health Centers
Same address
Community Health
697 W TEFFT ST
Nipomo, CA 93444
  • Reassigned Medicare billing, California enrollment
  • 263 clinicians in this Medicare group
NPI 1508237629 (805) 929-2272

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 10

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.
1,405 services365 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 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.
237 services171 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.
72 services61 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
67 services48 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.
42 services40 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.
37 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93444 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
$135.73 typical visit price
range $59.84 – $178.89
Typical copayment $33.93 (range $14.96 – $44.72)
Most-billed visit code 99204
Established Patient
$104.82 typical visit price
range $19.70 – $146.55
Typical copayment $26.20 (range $4.92 – $36.63)
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.

96.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.34
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 19

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
18 suppliers59 claims123 services$6.28 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
12 suppliers24 claims24 services$1.03 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers19 claims19 services$37.15 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers13 claims39 services$35.61 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers12 claims12 services$58.20 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers17 claims17 services$19.82 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 6

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

MS. MARISA ELIZABETH AYERS PA
Physician Assistant
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272
PACIFIC CENTRAL COAST HEALTH CENTERS
Clinic/Center (Community Health)
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272
DR. ANNA BELLE KIM M.D.
Internal Medicine
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272
JANELLE SUZANNE JOST FNP-BC
Nurse Practitioner (Family)
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272
JORDAN MARK READER DO
Family Medicine
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272
MRS. ELIZABETH EVANS N.P.
Nurse Practitioner (Family)
697 W TEFFT ST
NIPOMO, CA 93444
San Luis Obispo County (805) 929-2272

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 Sweeney's NPI number?

The NPI number for James Sweeney is 1932213014. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is James Sweeney located?

James Sweeney practices at 697 W Tefft St, Nipomo, CA 93444. The listed phone number is (805) 929-2272.

What is James Sweeney's specialty?

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

Is James Sweeney enrolled in Medicare?

Yes. James Sweeney 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 organization bills Medicare for James Sweeney's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Sweeney reassigns Medicare benefits to Pacific Central Coast Health Centers (Nipomo, CA). The 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 Sweeney's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for James Sweeney was last updated on December 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.