Individual provider Active NPI

James C Holler, MD

  • Family Medicine Physician
  • Endwell, NY
National Provider Identifier
1295755478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
173413 Issued in NY
Practice address
415 Hooper Road
Endwell Family Physicians LLP
Endwell, NY 13760-3698
Phone
(607) 754-3863
Fax
(607) 754-5697
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 173413 NY Primary

Addresses

Primary practice location

415 Hooper Road
Endwell Family Physicians LLP
Endwell, NY 13760-3698

Mailing address

415 Hooper Rd
Endwell, NY 13760-3698
Phone (607) 754-3863

Other identifiers 9

IdentifierTypeStateIssuer
88523OtherMVP SELECT
10031727OtherCDPHP
88523OtherMVP
01357340MedicaidNY
58142OtherGHI HMO
880592OtherAETNA HMO
9599400OtherGHI
4258763OtherAETNA
NY0043453OtherCHAMPUS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000282 NY Practitioner - Family Practice 1850295213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endwell Family Physicians LLPGroup PAC ID 9537063987, 26 clinicians

Practice addresses (Care Compare)

415 Hooper Rd
Endwell, NY 13760-3646
Phone (607) 754-3863

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.22 of 100Reported as group
Quality
78.62
Promoting interoperability
96
Improvement activities
40
Cost
68.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173413NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endwell Family Physicians LLP Family Medicine CurrentSince Nov 1, 1992 Accepting new patients

Locations

415 Hooper Rd
Endwell, NY 13760
Phone (607) 754-3863

Interoperability endpoints

  • Direct secure messaging: jholler@efp.medentdirect.com

Organizations & group practices 2

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 4

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295755478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 HOOPER RD",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137603698",
            "telephone_number": "607-754-3863",
            "fax_number": "607-754-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOOPER ROAD",
            "address_2": "ENDWELL FAMILY PHYSICIANS LLP",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137603698",
            "telephone_number": "607-754-3863",
            "fax_number": "607-754-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "JAMES",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "173413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP SELECT",
            "identifier": "88523",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10031727",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "88523",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01357340",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "58142",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "880592",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9599400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4258763",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "NY0043453",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Endwell, NY

Sources for this page

Verify at the official NPI Registry.