DR. JAMES P. RESTREPO M.D.
NPI 1972502573
Otolaryngology in Wyomissing, PA

Q: What is James Restrepo's NPI number?

The NPI number for James Restrepo is 1972502573. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Q: What is James Restrepo's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for James Restrepo was last updated on March 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 18, 2005PECOS EnrolledAccepts Medicare Assignment

88.93/100

CMS Quality Rating

985 BERKSHIRE BLVD, STE 101, WYOMISSING, PA 19610(610) 374-5599(610) 288-8075 Get Directions Write a Review

NPPES record last updated: March 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 14, 2023, Jan 21, 2021, Jul 29, 2020 (3 updates tracked since 2020).

On this page

About Dr. James P. Restrepo M.d. NPPES

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

DR. JAMES P. RESTREPO M.D. (NPI 1972502573) is an individual otolaryngology provider in Wyomissing, Pennsylvania, licensed in Pennsylvania (MD030575E) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (1982).

NPPES Registry Identity

NPI1972502573

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameDR. JAMES P. RESTREPOCredential: M.D.

Location Address985 BERKSHIRE BLVD, STE 101Wyomissing, PA 19610-1268

Mailing Address985 Berkshire Blvd, Ste 101Wyomissing, PA 19610-1268 · (610) 374-5599 · Fax (610) 288-8075

Phone(610) 374-5599

Fax(610) 288-8075

Sole ProprietorNo

Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 1982

Enumeration DateJuly 18, 2005

Last NPPES UpdateMarch 14, 20233 updates tracked since enumeration

NPPES CertifiedMarch 14, 2023

✔ NPI 1972502573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in PA · MD030575E

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

985 BERKSHIRE BLVD, Wyomissing, PA 19610

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Other Identifiers 8

Other065201PA · Highmark Blue Shield

Other1142932001PA · Cigna

Other30717APA · Amerihealth Mercy

Medicaid0010787880003PA

Other01487601PA · Capital Blue Cross

Other0075773000PA · Independence Blue Cross

Other55355PA · Aetna

Other0065201PA · Keystone Hp Central

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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. James P. Restrepo 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 ID9032213194

PECOS Enrollment IDI20100714000528

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 14

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 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.

360 services268 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

229 services157 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.

161 services135 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

136 services136 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

106 services98 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

88 services76 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

76 services52 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

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.

51 services51 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

24 services23 patients

Simple control of nose bleed 30901

Simple control of a nose bleed involves leaning forward slightly to prevent blood from flowing down the throat. Pinch your nostrils together and breathe through your mouth. This pressure can help the blood clot and stop the bleeding. Avoid lying down or blowing your nose.

24 services13 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

24 services23 patients

Repositioning exercises of head for treatment of dizziness, each day 95992

Repositioning exercises of the head help manage dizziness by training your brain to cope with the signals that trigger this sensation. Daily, gentle movements of the head and body can reduce symptoms and improve balance.

15 services14 patients

Incision, aspiration, and/or inflation of eardrum 69420

This procedure involves making a small cut in the eardrum to relieve pressure, remove fluid, or insert a tiny tube. It can help in conditions like chronic ear infections or hearing loss. It's a common, quick, and typically painless procedure.

12 services12 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks County

Emergency services Birthing friendly

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390096

Location2500 Bernville RoadReading, PA 19605 · Berks County

Emergency services Birthing friendly

Surgical Institute Of Reading

Acute Care Hospitals · Wyomissing, PA

OwnershipPhysician

CMS Certification Number390316

Location2752 Century BoulevardWyomissing, PA 19610 · Berks County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19610 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

88.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Promoting Interoperability

100

Improvement Activities

Cost

63.1

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

56%503 patients3/55-star benchmark: 92%

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

62%37 patients3/55-star benchmark: 95%

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.

98%2,018 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.

100%1,284 patients5/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

28%46 patients2/55-star benchmark: 88%

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.

98%3,886 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.

35%2,522 patients2/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

42%858 patients2/55-star benchmark: 90%

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…

39%1,643 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

26%674 patients2/55-star benchmark: 88%

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: 36% · 70 patients

Patients tobacco: 90% · 480 patients

98%480 patients5/55-star benchmark: 98%

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…

89%2,522 patients4/55-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.

4%2,522 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.

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.

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier15 claims444 services$4.32 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 8

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

DR. JEFFREY S. DRIBEN M.D.

Otolaryngology

985 BERKSHIRE BLVD, STE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

DR. CHARLES K. LUTZ M.D.

Otolaryngology

985 BERKSHIRE BLVD, STE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

MELANIE A. APPLER AU.D., FAAA

Audiologist

985 BERKSHIRE BLVD, STE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

ENT HEAD & NECK SPECIALISTS PC

Otolaryngology

985 BERKSHIRE BLVD, SUITE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

KATHLEEN D. VIVALDI AU.D., FAAA

Audiologist

985 BERKSHIRE BLVD, STE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

DR. MICHAEL G HASKER DMD

Dentist (General Practice)

985 BERKSHIRE BLVD, SUITE 100
WYOMISSING, PA 19610

Berks County (610) 376-3874

MATTHEW R BONSALL AUD.

Audiologist

985 BERKSHIRE BLVD, SUITE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

MRS. ROSEMARIE ABID MONTGOMERY FNP-C

Nurse Practitioner (Family)

985 BERKSHIRE BLVD, SUITE 101
WYOMISSING, PA 19610

Berks County (610) 374-5599

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 Restrepo's NPI number?

The NPI number for James Restrepo is 1972502573. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Where is James Restrepo located?

James Restrepo practices at 985 Berkshire Blvd Ste 101, Wyomissing, PA 19610. The listed phone number is (610) 374-5599.

What is James Restrepo's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is James Restrepo enrolled in Medicare?

Yes. James Restrepo 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 James Restrepo accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list James Restrepo 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 James Restrepo affiliated with any hospitals?

According to CMS data, James Restrepo is affiliated with Reading Hospital, Penn State Health St. Joseph and Surgical Institute Of Reading.

When was this NPI record last updated?

The NPPES record for James Restrepo was last updated on March 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.