Active NPI 1861659476 Individual Practitioner Male Practitioner

Dr. James M Lopes , MD

Surgery • West Orange, NJ

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. James Lopes, MD is a certified Surgery practicing in West Orange, NJ. With approximately 22 years of clinical experience since graduating from Albert Einstein College Of Medicine Of Yeshiva University in 2004, Dr. Lopes delivers high-quality medical care to the local community at 375 MOUNT PLEASANT AVE.

Dr. Lopes is affiliated with Summit Medical Group Pa and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

375 Mount Pleasant Ave

West Orange, NJ 070522750

Telephone 9737317707

Fax 9732322301

Associated Practice Facility / Clinic

🏢 Diagnostic & Clinical Cardiology, Pa Facility NPI 1760481493

Medicare Profile & Education

Medical School

Albert Einstein College Of Medicine Of Yeshiva University

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in West Orange, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs -5.4 yrs vs City Avg

City Avg: 27.4 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

9 Specialists

Practicing in West Orange, NJ (815 Statewide)

Telehealth Adoption Rate

22.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

85.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lopes (22 Years) 22 Yrs

West Orange Specialty Average (27.4 Years) 27.4 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
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	109	109	$412.00	$180.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	44	$274.00	$137.42
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	43	25	$179.00	$83.14
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	37	35	$497.00	$183.25
99213 Established patient office or other outpatient visit, typically 15 minutes	36	30	$188.00	$96.89
49650 Repair of groin hernia using an endoscope	31	31	$2888.03	$271.79
99231 Follow-up hospital inpatient care per day, typically 15 minutes	29	17	$97.00	$52.48
47562 Removal of gallbladder using an endoscope	25	25	$3798.76	$365.16
36415 Insertion of needle into vein for collection of blood sample	19	17	$15.00	$8.65
49505 Repair of groin hernia (5 years or older)	17	16	$2968.00	$312.29
80053 Blood test, comprehensive group of blood chemicals	14	13	$40.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	14	13	$32.00	$7.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$412.00	$185.98
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	67	38	$179.00	$86.48
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	49	46	$497.00	$189.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	47	36	$274.00	$143.29
47562 Removal of gallbladder using an endoscope	29	29	$3764.76	$322.03
99213 Established patient office or other outpatient visit, typically 15 minutes	23	19	$188.00	$101.53
36415 Insertion of needle into vein for collection of blood sample	22	22	$15.00	$8.40
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$116.00	$60.00
80053 Blood test, comprehensive group of blood chemicals	13	13	$40.00	$10.35
49650 Repair of groin hernia using an endoscope	13	13	$2773.62	$206.47
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	13	13	$32.00	$7.61
49594 Initial repair of entrapped hernia of abdomen, 3-10 cm in length	12	12	$4102.33	$513.68
49505 Repair of groin hernia (5 years or older)	11	11	$2968.00	$227.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	108	57	$179.00	$77.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$412.00	$187.98
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	48	46	$497.00	$215.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	18	$274.00	$144.76
36415 Insertion of needle into vein for collection of blood sample	18	18	$15.00	$2.96
99213 Established patient office or other outpatient visit, typically 15 minutes	18	13	$188.00	$103.10
47562 Removal of gallbladder using an endoscope	17	17	$4046.59	$264.57
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$336.00	$146.90
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	15	15	$516.00	$248.24
44120 Partial removal of small bowel	11	11	$7024.36	$922.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	95	50	$179.00	$76.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	46	46	$497.00	$219.44
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	33	33	$516.00	$243.68
47562 Removal of gallbladder using an endoscope	25	25	$6483.60	$402.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$412.00	$184.08
36415 Insertion of needle into vein for collection of blood sample	16	16	$15.00	$3.00
99213 Established patient office or other outpatient visit, typically 15 minutes	15	12	$188.00	$104.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	13	$274.00	$147.33
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$336.00	$137.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	95	41	$213.39	$80.45
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	48	45	$536.94	$225.14
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	16	16	$516.00	$220.56
47562 Removal of gallbladder using an endoscope	15	15	$6544.13	$505.62
99213 Established patient office or other outpatient visit, typically 15 minutes	13	13	$216.00	$85.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	40	26	$300.00	$78.99
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$345.00	$120.88
99213 Established patient office or other outpatient visit, typically 15 minutes	22	17	$240.00	$83.08
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	15	$710.00	$219.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	34	21	$240.00	$80.88
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	34	25	$300.00	$72.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$346.52	$119.29
49560 Repair of incisional or abdominal hernia	17	17	$6963.81	$370.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$710.00	$218.83
47562 Removal of gallbladder using an endoscope	11	11	$6772.83	$255.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	36	19	$240.00	$80.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$345.00	$119.30
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	23	21	$710.00	$218.25
49505 Repair of groin hernia (5 years or older)	13	13	$5210.00	$532.54
47562 Removal of gallbladder using an endoscope	13	13	$8515.38	$445.47

Medical Specialties & State Licenses

CMS Verified: 2020-05-15

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NJ 25MA08930100

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.

Hospital & Practice Group Affiliations

Summit Medical Group Pa

1 Diamond Hill Rd, Berkeley Heights, NJ 079222104

Phone: 9082734300

Practice Associates & Co-Workers

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

21 Associated Practitioners

Dr. Derek Lim , DO

Surgery

NPI 1033567383

Doctor of Osteopathic Medicine (D.O.)

Dr. Joao Lopes , MD

Surgery

NPI 1043268378

Doctor of Medicine (M.D.)

Dr. Zem Walk , MD

Obstetrics & Gynecology - Gynecology

NPI 1043310907

Doctor of Medicine (M.D.)

Dr. Stephen Crane , MD

Obstetrics & Gynecology

NPI 1073613998

Doctor of Medicine (M.D.)

Dr. Daniel Sansobrino , MD

Obstetrics & Gynecology

NPI 1174726491

Doctor of Medicine (M.D.)

Dr. Neil Russo , MD

Obstetrics & Gynecology

NPI 1235290966

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location May 15, 2020

Registered at 375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 070522750 (Tel: 9737317707)

📍

Updated Business Mailing Address May 15, 2020

Registered at 375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 070522750 (Tel: 9737317707)

✅

NPI Profile Active December 30, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location December 30, 2011

Registered at 155 MORRIS AVE, 2ND FLOOR, SPRINGFIELD, NJ 070811225 (Tel: 9732322300)

📍

Updated Business Mailing Address December 30, 2011

Registered at 155 MORRIS AVE, 2ND FLOOR, SPRINGFIELD, NJ 070811225 (Tel: 9732322300)

👤

Provider Name / Credentials Updated December 30, 2011

Recorded as JAMES LOPES, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2011

Surgery (License #25MA08930100 in NJ)

🟢

Initial NPI Registration & Enumeration May 21, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1861659476

Entity Type:

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

Enumeration Date: May 21, 2008

Last Update: May 15, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

375 Mount Pleasant Ave

West Orange, NJ 070522750

Phone: 9737317707

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.