Individual provider Active NPI

James Garner Williams, MD

  • Otolaryngology Physician
  • Covina, CA
National Provider Identifier
1316924608
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A48653 Issued in CA
Practice address
202 West College St
Covina, CA 91723-1902
Phone
(626) 966-2111
Fax
(626) 967-6315
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A48653 CA Primary

Addresses

Primary practice location

202 West College St
Covina, CA 91723-1902

Mailing address

202 West College St
Covina, CA 91723-1902
Phone (626) 966-2111

Other identifiers 1

IdentifierTypeStateIssuer
00A486530MedicaidCA

Other names 1

  • James Garner Williams Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090820000217 CA Practitioner - Otolaryngology 9234283557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Baylor College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 W College St
Covina, CA 91723-1902
Phone (626) 966-2111

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48653CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covina Ear Nose & Throat Medical Group Inc Otolaryngology CurrentSince Jul 1, 1994 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Leon Bachoura, M.D., Inc. PastSince Jul 1, 1994 Accepting new patients
Inland Valley Surgical Partners, LLC PastSince May 1, 2010 Accepting new patients

Locations

202 W College St
Covina, CA 91723
Phone (626) 966-2111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jameswilliams@centmgi.allscriptsdirect.net

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1316924608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 WEST COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-966-2111",
            "fax_number": "626-967-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 WEST COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-966-2111",
            "fax_number": "626-967-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAMES",
        "middle_name": "GARNER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A48653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A486530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "WILLIAMS",
            "middle_name": "GARNER",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.