DR. JAMES P WILTON DPM
NPI 1942490776
Podiatrist - Foot & Ankle Surgery in Claremont, NH
NPI Status: Active since July 27, 2007
Contact Information
241 ELM STREET
CLAREMONT, NH
ZIP 03743
Phone: (603) 542-7666
Fax: (603) 543-9612
- Individual
- Male
- Years of Experience 42
- Podiatrist
- Foot & Ankle Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JAMES WILTON
This page provides the complete NPI Profile along with additional information for James Wilton, a provider established in Claremont, New Hampshire with a medical specialization in Podiatrist, focusing in foot & ankle surgery and more than 42 years of experience. He graduated from Temple University School Of Podiatric Medicine in 1984. The healthcare provider is registered in the NPI registry with number 1942490776 assigned on July 2007. The practitioner's primary taxonomy code is 213ES0103X with license number 0183 (NH). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1942490776
- Provider Name
- DR. JAMES P WILTON DPM
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 241 ELM STREET CLAREMONT, NH 03743
- Location Phone
- (603) 542-7666
- Location Fax
- (603) 543-9612
- Mailing Address
- 243 ELM STREET CLAREMONT, NH 03743
- Mailing Phone
- (603) 543-6940
- Mailing Fax
- (603) 543-9612
- Medical School Name
- TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
- Graduation Year
- 1984
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-27-2007
- Last Update Date
- 11-14-2016
- Code Navigator
Location Map
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
Podiatrist Foot & Ankle Surgery
- Taxonomy Code
- 213ES0103X
- Type
- Podiatric Medicine & Surgery Service Providers
- License No.
- 0183
- License State
- NH
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) |
|---|---|---|---|---|
| 1 | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | POD212 (ME) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/7500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/30%/9000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2500/30%/10000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/10000 - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/20%/8500 - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 7000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
- NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
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 |
|---|---|---|---|
| 3098479 | MEDICAID (05) | NH | |
| T25738 | MEDICARE UPIN (02) | NH |
Medicare Participation & PECOS Enrollment Status
James Wilton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
James Wilton 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: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
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
PECOS PAC ID: 5496790271
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050622000722, I20100915000131
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| e-Prescribing | 96% | 128 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 99% | 276 |
| 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. | ||
| Patient-Specific Education | 11% | 506 |
| 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. | ||
| Provide Patient Access | 65% | 506 |
| 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 certain information. | ||
| Secure Messaging | 5% | 506 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. James Wilton is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| PORTSMOUTH REGIONAL HOSPITAL | 333 BORTHWICK AVE PORTSMOUTH, NH 03801 | (603) 436-5110 | Acute Care Hospitals | |
| COTTAGE HOSPITAL | 90 SWIFTWATER RD WOODSVILLE, NH 03785 | (603) 747-9000 | Critical Access Hospitals | |
| VALLEY REGIONAL HOSPITAL | 243 ELM STREET CLAREMONT, NH 03743 | (603) 542-7771 | Critical Access Hospitals |
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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 1942490776, we treat the final digit (6) 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 74 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
CLAREMONT, NH 03743
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942490776, enumerated as an "individual" on July 27, 2007.
The provider is located at 241 ELM STREET CLAREMONT, NH 03743 and the phone number is (603) 542-7666.
Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
James Wilton is affiliated with: PORTSMOUTH REGIONAL HOSPITAL, COTTAGE HOSPITAL and VALLEY REGIONAL HOSPITAL.
