JAMES L WATKINS M.D.
NPI 1326002395
Internal Medicine - Gastroenterology in Indianapolis, IN

Medicare Participation & PECOS Enrollment Status

James Watkins 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 Watkins 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), a Home Health Agency (HHA) and Power Mobility Devices.

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: 7810986775

  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: I20040507000275

  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: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Colonoscopy

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

This service was performed for 1-10 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 134 times for 55 patients

Incision of pancreatic outlet using a flexible endoscope

This procedure involves a small cut in the outlet of the pancreas using a flexible tube with a camera, called an endoscope. It helps doctors diagnose and treat conditions affecting the pancreas, enhancing patient comfort and recovery.

This service was performed 44 times for 44 patients

Initial hospital inpatient care per day, typically 70 minutes

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.

This service was performed 50 times for 49 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

This service was performed 64 times for 44 patients

Removal of stent from pancreatic or bile duct using a flexible endoscope

This procedure involves removing a stent from your pancreatic or bile duct. A flexible endoscope, a thin tube with a light and camera, is used to locate the stent. Once found, it's carefully extracted. This helps maintain proper duct function.

This service was performed 37 times for 36 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

This service was performed 92 times for 80 patients

Replacement of stent in pancreatic or bile duct using a flexible endoscope

This procedure involves replacing an existing stent in your pancreatic or bile duct. A flexible endoscope, a tube-like device with a light and camera, is used to view and access the area. The old stent is removed and a new one is placed to help keep the duct open.

This service was performed 48 times for 22 patients

Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope

This procedure involves a radiologist examining images from a tube placement in your bile and pancreatic duct. An endoscope, a flexible tube with a light and camera, is used to help guide this process. It assists in diagnosing and treating conditions related to these ducts.

This service was performed 32 times for 27 patients

Review by radiologist of image from tube placement into bile duct using an endoscope

This procedure involves a specialist, called a radiologist, examining an image taken during a tube placement into your bile duct. The tube is inserted with the help of a tool called an endoscope. This allows the doctor to check for any issues or abnormalities in your bile duct.

This service was performed 108 times for 85 patients

Review by radiologist of image from tube placement into pancreatic duct using an endoscope

This procedure involves an expert radiologist examining an image obtained from a tube placement into your pancreatic duct. An endoscope, a flexible tube with a camera, is used for this process. The aim is to assess the condition of your pancreas and ducts.

This service was performed 17 times for 11 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 245 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 46202 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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 Watkins is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1326002395 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions