JAMES F LOOMIS JR. MD
NPI 1528153160
Internal Medicine in Washington, DC
NPI Status: Active since October 03, 2006
Contact Information
5100 WISCONSIN AVE NW
STE 401
WASHINGTON, DC
ZIP 20016
Phone: (202) 527-7500
- Individual
- Male
- Years of Experience 41
- Internal Medicine
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JAMES LOOMIS
This page provides the complete NPI Profile along with additional information for James Loomis, an internist established in Washington, District Of Columbia with a medical specialization in Internal Medicine and more than 41 years of experience. He graduated from University Of Arkansas College Of Medicine in 1985. The healthcare provider is registered in the NPI registry with number 1528153160 assigned on October 2006. The practitioner's primary taxonomy code is 207R00000X with license number MD043764 (DC). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1528153160
- Provider Name
- JAMES F LOOMIS JR. MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5100 WISCONSIN AVE NW STE 401 WASHINGTON, DC 20016
- Location Phone
- (202) 527-7500
- Mailing Address
- 5100 WISCONSIN AVE NW STE 401 WASHINGTON, DC 20016
- Mailing Phone
- (202) 527-7500
- Medical School Name
- UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
- Graduation Year
- 1985
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-03-2006
- Last Update Date
- 03-31-2016
- Code Navigator
An internist like James Loomis is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD043764
- License State
- DC
- Taxonomy Description
- 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.
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 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | R8G21 (MO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| MA2226001 | MEDICARE PIN (08) | MO | |
| 202463857 | MEDICAID (05) | MO | |
| A13751 | MEDICARE UPIN (02) | MO | |
| 001013534 | MEDICARE ID-TYPE UNSPECIFIED (04) | MO | MEDICARE MO |
Medicare Participation & PECOS Enrollment Status
James Loomis 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 Loomis 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: 7618036039
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: I20160503000044
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 16 Medicare Claims 24 Services Paid
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.
Annual alcohol misuse screening, 15 minutes
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 45-59 minutes
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
This service was performed 54 times for 54 patientsAn annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
This service was performed 50 times for 50 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 50 times for 50 patientsThis is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.
This service was performed 54 times for 54 patientsThis 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.
This service was performed 171 times for 90 patientsThis 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.
This service was performed 17 times for 17 patientsThis 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.
This service was performed 11 times for 11 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.96 for a new patient copayment and $28.43 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 20016 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $147.85
- Minimum New Patient Price $65.18
- Maximum New Patient Price $194.86
- Average New Patient Copayment $36.96
- Minimum New Patient Copayment $16.29
- Maximum New Patient Copayment $48.71
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $113.72
- Minimum Established Patient Price $21.4
- Maximum Established Patient Price $158.88
- Average Established Patient Copayment $28.43
- Minimum Established Patient Copayment $5.35
- Maximum Established Patient Copayment $39.72
* 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.
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 |
|---|---|---|
| Care Plan | 12% | 74 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| 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. | ||
| Colorectal Cancer Screening | 29% | 228 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 5% | 59 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| e-Prescribing | 88% | 525 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 26% | 258 |
| 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 at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| 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 | 100% | 236 |
| 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 | 29% | 439 |
| 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. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 68% | 427 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 24% | 323 |
| 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 | ||
| Provide Patient Access | 99% | 439 |
| 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 | 83% | 439 |
| 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. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| 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. | ||
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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.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 2 | 8 | 1 | 5 | 3 | 1 | 6 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 4 | 8 | 2 | 5 | 6 | 1 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 4 + 8 + 2 + 5 + 6 + 1 + 1 + 2 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1528153160 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1396780128 | DR. LAYSHIA T FOWLER D.P.M. Individual | Podiatrist | 5100 WISCONSIN AVE NW SUITE 522 WASHINGTON, DC 20016 (202) 966-0900 |
| 1245346238 | MR. JAY M. MUTCHNIK P.T. Individual | Physical Therapist | 5100 WISCONSIN AVE NW SUITE 522 WASHINGTON, DC 20016 (202) 966-0900 |
| 1720174279 | APRIL GATES LICSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1861573859 | MRS. ELIZABETH EHRENHAFT RANKIN MSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1871678524 | MRS. ANNE PATRICIA BURROWS MSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE #300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1336225804 | EROSALIND H KAYE MSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (202) 244-1270 |
| 1912084443 | MS. ERICA MARGARET HANSON LICSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1306993779 | DR. RALPH THOMAS MAZZUCA DDS Individual | Dentist | 5100 WISCONSIN AVE NW SUITE 406 WASHINGTON, DC 20016 (202) 537-1088 |
| 1457563686 | DR. MAHNAZ SHAHINFAR D.D.S., D.M.D. Individual | Dentist (Pediatric Dentistry) | 5100 WISCONSIN AVE NW SUITE # 309 WASHINGTON, DC 20016 (202) 363-1537 |
| 1952586760 | NATIONAL CAPITAL FOOT & ANKLE CENTER Organization | Durable Medical Equipment & Medical Supplies (Customized Equipment) | 5100 WISCONSIN AVE NW SUITE #522 WASHINGTON, DC 20016 (202) 966-0900 |
| 1629247499 | ALI R. ZIGLARI, DDS, PC Organization | Dentist (General Practice) | 5100 WISCONSIN AVE NW SUITE 210 WASHINGTON, DC 20016 (202) 966-9643 |
| 1417121526 | DR. SHERI NAWABI DDS Individual | Dentist (General Practice) | 5100 WISCONSIN AVE NW STE 240 WASHINGTON, DC 20016 (202) 686-2318 |
| 1427207984 | DR. MELISSA DAWN WINDSOR DC Individual | Chiropractor | 5100 WISCONSIN AVE NW SUITE 251 WASHINGTON, DC 20016 (202) 362-0900 |
| 1801112545 | MS. MICHELE GREENE MORIARITY LPC Individual | Counselor (Professional) | 5100 WISCONSIN AVE NW WASHINGTON, DC 20016 (202) 244-8855 |
| 1356655575 | MR. PHILIP MICHAEL CONKLIN MSW, LICSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW # 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1710273081 | ANDREW POLLOCK M.S.W., LICSW Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (443) 857-6211 |
| 1336416544 | MR. DANIEL M KAVANAUGH MSW, LCSW-C Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1508131863 | MR. MICHAEL ANDREW TOTH LCSW-C Individual | Social Worker (Clinical) | 5100 WISCONSIN AVE NW # 300 WASHINGTON, DC 20016 (202) 244-8855 |
| 1184967481 | SHERI NAWABI, D.D.S., PLLC Organization | Dentist (General Practice) | 5100 WISCONSIN AVE NW SUITE 240 WASHINGTON, DC 20016 (202) 686-2318 |
| 1043651466 | DR. EMILY M BAUMAN PH.D. Individual | Psychologist | 5100 WISCONSIN AVE NW SUITE 300 WASHINGTON, DC 20016 (240) 461-8149 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528153160, enumerated in the NPI registry as an "individual" on October 03, 2006
The provider is located at 5100 Wisconsin Ave Nw Ste 401 Washington, Dc 20016 and the phone number is (202) 527-7500
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 41 years of experience. He graduated from University Of Arkansas College Of Medicine in 1985.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $147.85 with an average copayment of $36.96 for new patient appointments. Established patients should expect a typical charge of $113.72 and an average copayment of 28.43. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Annual alcohol misuse screening, 15 minutes, Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes and New patient office or other outpatient visit, 45-59 minutes.
This NPI record was last updated on October 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.