NPIMap

Individual provider Active NPI

James Tyreill Walters, DO

  • Emergency Medicine Physician
  • Monroe, MI
National Provider Identifier
1134610595
Registry record updated Mar 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101023968 Issued in MI
Practice address
718 N Macomb St
Monroe, MI 48162-7815
Phone
(734) 240-8400
Fax
(734) 240-1997
NPI assigned
May 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101023968 MI Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X 5101023968 MI

Addresses

Primary practice location

718 N Macomb St
Monroe, MI 48162-7815

Mailing address

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210709002065 OH Practitioner - Emergency Medicine 0345642518 Reassigns benefits to 3 organizations
I20210714001694 MI Practitioner - Emergency Medicine 0345642518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Toledo HospitalGroup PAC ID 2961309638, 118 clinicians
Emergency Physicians of Northwest Ohio, Inc.Group PAC ID 3375456478, 102 clinicians
Observation Physicians of Northwest Ohio LLCGroup PAC ID 7416365630, 37 clinicians

Practice addresses (Care Compare)

1075 Medical Ctr Pkwy
Maumee, OH 43537
Phone (567) 585-0800

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.25 of 100Reported as group
Quality
96.55
Improvement activities
40
Cost
89.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101023968MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Haematology-Oncology Associates of Ohio and Michigan PC Single Specialty Current Accepting new patients
Emergency Physicians of Northwest Ohio Inc. Single Specialty CurrentSince Jun 15, 2021 Accepting new patients
The Toledo Hospital CurrentSince Jan 21, 2022 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Single Specialty Current Accepting new patients
The Toledo Hospital Single Specialty CurrentSince Jan 21, 2022 Accepting new patients
Observation Physicians of Northwest Ohio LLC Single Specialty CurrentSince Jun 27, 2021 Accepting new patients
Lima Memorial Joint Operating Company Single Specialty Past Accepting new patients

Locations

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

1075 Medical Center Pkwy
Maumee, OH 43537
Phone (567) 585-0800

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1134610595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481627815",
            "telephone_number": "734-240-8400",
            "fax_number": "734-240-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481627815",
            "telephone_number": "734-240-8400",
            "fax_number": "734-240-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JAMES",
        "middle_name": "TYREILL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101023968",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101023968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.