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JAMES R MARTIN MD
NPI 1972592541
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Warren, MI

Active since October 17, 2005PECOS EnrolledAccepts Medicare Assignment
11900 E 12 MILE RD, SUITE 205, WARREN, MI 48093(586) 576-4907(576) 576-4906 Get Directions Write a Review

NPPES record last updated: February 23, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About James R Martin Md NPPES

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

JAMES R MARTIN MD (NPI 1972592541) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Warren, Michigan, licensed in Michigan (063638) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Mclaren Northern Michigan, and is a graduate of University Of Vermont College Of Medicine (1986).

NPPES Registry Identity

NPI1972592541
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameJAMES R MARTINCredential: MD
Location Address11900 E 12 MILE RD, SUITE 205Warren, MI 48093-3400
Mailing Address11900 E 12 Mile Rd, Suite 205Warren, MI 48093-3400 · (586) 576-4907 · Fax (576) 576-4906
Phone(586) 576-4907
Fax(576) 576-4906
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 1986
Enumeration DateOctober 17, 2005
Last NPPES UpdateFebruary 23, 2017
✔ NPI 1972592541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in MI · 063638
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
11900 E 12 MILE RD, Warren, MI 48093
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINF81497

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

James R Martin 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 ID5496794018
PECOS Enrollment IDI20050503000358
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 4

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services21 patients
Replacement of aortic valve through the skin and femoral artery 33361
This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.
21 services21 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.
18 services18 patients
Exclusion of appendage of left upper chamber of heart performed during other procedure on chest 33268
This is a procedure done on the heart's left upper chamber (atrium). The small pouch-like appendage is sealed off during another chest procedure. This is done to reduce the risk of blood clots forming and causing strokes.
14 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230105
Location416 Connable AvePetoskey, MI 49770 · Emmet County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230216
Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48093 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
$177.36 typical visit price
range $58.04 – $177.36
Typical copayment $44.34 (range $14.51 – $44.34)
Most-billed visit code 99205
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
32%38 patients2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
25%24 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
19%127 patients1/55-star benchmark: 85%
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.
95%428 patients4/55-star benchmark: 100%
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.
92%116 patients3/55-star benchmark: 100%
Patient Centered Surgical Risk Assessment and Communication for Cardiac Surgery
Percentage of patients age 18 and older undergoing a non-emergency risk modeled cardiac surgery procedure that had personalized risk assessment using the STS risk calculator and discussed those risks with the surgeon.
53%47 patients3/55-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.
60%257 patients3/55-star benchmark: 97%
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…
27%202 patients2/55-star benchmark: 97%
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: 81% · 27 patients
100%49 patients5/55-star benchmark: 100%
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…
52%257 patients3/55-star benchmark: 100%
Secure Messaging
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…
18%257 patients1/55-star benchmark: 89%
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.
15%257 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.

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.

ASCENSION MEDICAL GROUP MICHIGAN
Orthopaedic Surgery
11900 E 12 MILE RD, SUITE 110
WARREN, MI 48093
Macomb County (586) 582-7070
SALIM MERAM MD
Internal Medicine
11900 E 12 MILE RD, SUITE 100
WARREN, MI 48093
Macomb County (586) 573-5890
DAVID H MENDELSON MD
Orthopaedic Surgery
11900 E 12 MILE RD, SUITE 110
WARREN, MI 48093
Macomb County (586) 582-7070
KIM MARGOLIS MD
Internal Medicine
11900 E 12 MILE RD, SUITE 200
WARREN, MI 48093
Macomb County (586) 558-9033
SARAH MCKENDRICK HAVENS P.A.
Physician Assistant
11900 E 12 MILE RD, SUITE 110
WARREN, MI 48093
Macomb County (586) 261-2600
JILL F. DELY PA-C
Physician Assistant
11900 E 12 MILE RD, SUITE 103
WARREN, MI 48093
Macomb County (586) 574-0890
ANTHONY P. BARON MD
Internal Medicine (Rheumatology)
11900 E 12 MILE RD, SUITE 300
WARREN, MI 48093
Macomb County (586) 751-2072
LINGAREDDY DEVIREDDY MD PC
Clinic/Center (Medical Specialty)
11900 E 12 MILE RD, SUITE 103
WARREN, MI 48093
Macomb County (586) 574-0890

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 Martin's NPI number?

The NPI number for James Martin is 1972592541. It was assigned to this individual provider in the NPPES registry on October 17, 2005.

Where is James Martin located?

James Martin practices at 11900 E 12 Mile Rd Suite 205, Warren, MI 48093. The listed phone number is (586) 576-4907.

What is James Martin's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is James Martin enrolled in Medicare?

Yes. James Martin 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 Martin accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list James Martin 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 Martin affiliated with any hospitals?

According to CMS data, James Martin is affiliated with Mclaren Northern Michigan, Ascension St John Hospital and Mclaren Port Huron.

When was this NPI record last updated?

The NPPES record for James Martin was last updated on February 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.