Active NPI 1972548147 Individual Practitioner Male Practitioner

Dr. James D Pilkington , MD

Surgery • Alma, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. James Pilkington, MD is a certified Surgery practicing in Alma, MI. With approximately 31 years of clinical experience since graduating from Michigan State University College Of Human Medicine in 1995, Dr. Pilkington delivers high-quality medical care to the local community at 315 E WARWICK DR.

Dr. Pilkington is affiliated with Jeffrey Smith, Md Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

315 E Warwick Dr
Ste 3

Alma, MI 488011083

Telephone 9894636699

Fax 9894662574

Associated Practice Facility / Clinic

🏢 Mymichigan Medical Center Alma Facility NPI 1750309209

Medicare Profile & Education

Medical School

Michigan State University College Of Human Medicine

Graduation Year

1995

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Alma, MI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

31 Yrs +1.0 yrs vs City Avg

City Avg: 30.0 Yrs

State Avg: 25.8 Yrs

Regional Practice Density

5 Specialists

Practicing in Alma, MI (1479 Statewide)

Telehealth Adoption Rate

20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

74.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Pilkington (31 Years) 31 Yrs

Alma Specialty Average (30.0 Years) 30.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	223	177	$130.00	$85.12
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$165.00	$105.46
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	50	50	$608.00	$106.62
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	50	49	$1000.00	$237.95
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	47	47	$780.00	$174.37
45378 Diagnostic exam of large bowel using a flexible endoscope	40	38	$780.00	$159.39
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	32	32	$780.00	$169.93
45380 Biopsy of large bowel using an endoscope	30	30	$903.00	$136.76
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	26	26	$550.00	$91.07
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	15	$110.00	$76.70
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	19	$225.00	$121.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	16	$75.00	$51.90
99221 Initial hospital inpatient care per day, typically 30 minutes	13	13	$200.00	$81.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	201	170	$122.44	$84.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	91	90	$165.00	$104.50
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	43	43	$780.00	$171.82
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	41	41	$780.00	$176.27
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	41	41	$1000.00	$233.91
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	40	37	$608.00	$113.45
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	33	28	$200.00	$111.55
45378 Diagnostic exam of large bowel using a flexible endoscope	31	31	$780.00	$164.52
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	25	25	$550.00	$100.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	16	$180.00	$116.41
47562 Removal of gallbladder using an endoscope	17	17	$2280.00	$645.42
45380 Biopsy of large bowel using an endoscope	16	16	$903.00	$173.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$75.00	$49.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	136	122	$75.00	$53.71
99213 Established patient office or other outpatient visit, typically 15 minutes	107	89	$120.00	$85.44
99202 New patient office or other outpatient visit, typically 20 minutes	67	67	$120.00	$70.23
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	58	58	$780.00	$179.29
45378 Diagnostic exam of large bowel using a flexible endoscope	45	45	$780.00	$168.59
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43	39	$608.00	$106.22
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$165.00	$107.62
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	40	39	$200.00	$93.82
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	38	38	$780.00	$175.15
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	29	29	$1000.00	$242.23
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	23	23	$550.00	$95.74
45380 Biopsy of large bowel using an endoscope	17	17	$903.00	$194.76
49505 Repair of groin hernia (5 years or older)	14	14	$1340.57	$555.84
47562 Removal of gallbladder using an endoscope	13	13	$2280.00	$653.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$180.00	$123.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	143	143	$119.65	$69.93
99213 Established patient office or other outpatient visit, typically 15 minutes	95	85	$120.00	$87.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	77	75	$180.00	$123.98
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	72	72	$780.00	$173.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	56	$75.00	$54.11
45378 Diagnostic exam of large bowel using a flexible endoscope	54	54	$780.00	$175.43
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	50	49	$1000.00	$245.30
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	45	45	$608.00	$109.00
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	39	39	$780.00	$171.35
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	27	27	$200.00	$100.63
45380 Biopsy of large bowel using an endoscope	23	23	$903.00	$161.26
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	22	22	$550.00	$93.17
47562 Removal of gallbladder using an endoscope	19	19	$2280.00	$557.62
99442 Telephone medical discussion with physician, 11-20 minutes	12	12	$145.00	$84.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	115	115	$120.00	$71.96
99213 Established patient office or other outpatient visit, typically 15 minutes	81	72	$120.00	$71.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	81	69	$75.00	$43.55
45378 Diagnostic exam of large bowel using a flexible endoscope	49	49	$780.00	$166.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	42	$180.00	$101.93
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	38	38	$1000.00	$249.50
99441 Telephone medical discussion with physician, 5-10 minutes	38	36	$87.00	$44.10
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	31	31	$608.00	$109.25
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	27	27	$780.00	$177.48
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	27	27	$780.00	$188.26
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	25	25	$550.00	$99.36
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	23	23	$184.78	$103.81
45380 Biopsy of large bowel using an endoscope	18	18	$903.00	$181.51
49505 Repair of groin hernia (5 years or older)	18	18	$1498.83	$590.98
47562 Removal of gallbladder using an endoscope	16	16	$2187.50	$640.45
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	13	13	$2000.00	$342.56
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	12	12	$140.00	$18.77
76937 Ultrasonic guidance for blood vessel access	12	12	$140.00	$14.55
99442 Telephone medical discussion with physician, 11-20 minutes	11	11	$145.00	$71.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	300	300	$119.87	$72.91
99213 Established patient office or other outpatient visit, typically 15 minutes	219	190	$120.09	$70.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	107	102	$179.44	$104.67
45378 Diagnostic exam of large bowel using a flexible endoscope	89	88	$780.00	$177.06
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	81	80	$608.00	$122.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	78	51	$75.58	$43.28
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	69	69	$1000.00	$248.01
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	54	54	$780.00	$177.60
99221 Initial hospital inpatient care per day, typically 30 minutes	37	35	$200.00	$100.20
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	36	36	$780.00	$180.55
99231 Follow-up hospital inpatient care per day, typically 15 minutes	33	20	$100.00	$38.89
47562 Removal of gallbladder using an endoscope	31	31	$2280.00	$662.13
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	23	22	$550.00	$86.72
45380 Biopsy of large bowel using an endoscope	21	21	$903.00	$176.31
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$225.00	$135.11
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	17	17	$1075.00	$177.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	252	252	$119.92	$71.19
99213 Established patient office or other outpatient visit, typically 15 minutes	209	181	$100.19	$68.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	82	56	$75.00	$41.46
45378 Diagnostic exam of large bowel using a flexible endoscope	76	73	$780.00	$168.16
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	71	69	$608.00	$116.13
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	56	55	$1000.00	$241.93
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	51	51	$780.00	$168.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	49	49	$140.00	$100.77
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	33	33	$780.00	$187.34
99221 Initial hospital inpatient care per day, typically 30 minutes	31	31	$200.00	$99.56
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	29	28	$550.00	$94.47
45380 Biopsy of large bowel using an endoscope	28	28	$903.00	$157.30
99231 Follow-up hospital inpatient care per day, typically 15 minutes	25	19	$100.00	$38.52
47562 Removal of gallbladder using an endoscope	22	21	$2212.73	$602.67
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	22	22	$1075.00	$149.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$150.00	$104.09
99218 Hospital observation care typically 30 minutes	16	16	$250.00	$98.20
45381 Injection beneath lining of large bowel using a flexible endoscope	12	11	$1031.00	$16.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes	252	252	$119.92	$69.18
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	161	121	$75.00	$40.13
99213 Established patient office or other outpatient visit, typically 15 minutes	128	108	$100.00	$68.03
45378 Diagnostic exam of large bowel using a flexible endoscope	81	80	$780.00	$172.17
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	79	79	$608.00	$112.17
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$150.00	$101.58
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	56	56	$780.00	$176.05
99221 Initial hospital inpatient care per day, typically 30 minutes	52	51	$200.00	$97.21
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	50	50	$1000.00	$210.72
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	40	40	$780.00	$177.33
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	38	38	$550.00	$105.47
99231 Follow-up hospital inpatient care per day, typically 15 minutes	38	20	$100.00	$37.58
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	25	25	$1075.00	$189.67
45380 Biopsy of large bowel using an endoscope	24	24	$903.00	$176.09
47562 Removal of gallbladder using an endoscope	23	23	$2280.00	$640.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	22	$140.00	$101.05

Medical Specialties & State Licenses

CMS Verified: 2024-05-07

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MI 4301065547

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

4426885 (MI)

Hospital & Practice Group Affiliations

Jeffrey Smith, Md Pc

315 E Warwick Dr, Alma, MI 488011083

Phone: 9894636699

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Dr. Ernest Cudjoe , MD

Surgery

NPI 1063411742

Doctor of Medicine (M.D.)

Nichola Jardas , PA-C

Physician Assistant

NPI 1083669402

Physician Assistant (Certified)

Dr. Christina Downer , DO

Family Medicine

NPI 1477907350

Doctor of Osteopathic Medicine (D.O.)

Dr. Jeffrey Bonacci , MD

Surgery

NPI 1558575829

Doctor of Medicine (M.D.)

Kegan Rogers

Physician Assistant - Surgical

NPI 1558857920

Dr. Jeffrey Smith , MD

Surgery

NPI 1831197979

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active April 07, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 07, 2017

Registered at 315 E WARWICK DR, STE 3, ALMA, MI 488011083 (Tel: 9894636699)

📍

Updated Business Mailing Address April 07, 2017

Registered at 315 E WARWICK DR, STE 3, ALMA, MI 488011083 (Tel: 9894636699)

👤

Provider Name / Credentials Updated April 07, 2017

Recorded as JAMES PILKINGTON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 07, 2017

Surgery (License #4301065547 in MI)

✅

NPI Profile Active July 10, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location July 10, 2009

Registered at 1201 SOUTH DR, STE 352, MT PLEASANT, MI 488583256 (Tel: 9897795688)

📍

Updated Business Mailing Address July 10, 2009

Registered at 1201 SOUTH DR, STE 352, MT PLEASANT, MI 488583256 (Tel: 9897795688)

👤

Provider Name / Credentials Updated July 10, 2009

Recorded as JAMES PILKINGTON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2009

Surgery (License #4301065547 in MI)

🟢

Initial NPI Registration & Enumeration June 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972548147

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 19, 2006

Last Update: May 07, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

315 E Warwick Dr, Ste 3

Alma, MI 488011083

Phone: 9894636699

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.