Active NPI 1922114347 Individual Practitioner Female Practitioner

Heather R James , PA-C

Physician Assistant • Sheboygan, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Heather James, PA-C is a certified Physician Assistant practicing in Sheboygan, WI. With approximately 22 years of clinical experience since completing medical education in 2004, Heather James delivers high-quality medical care to the local community at 3400 UNION AVE.

Heather James is affiliated with Aurora Medical Group, Inc. and accepts Medicare assignment.

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

Practice Location & Contact Primary Location

Practice Address

3400 Union Ave

Sheboygan, WI 530818426

Telephone 9208282700

Fax 9208282905

Associated Practice Facility / Clinic

🏢 Aurora Health Care Central, Inc. Facility NPI 1922053107

Medicare Profile & Education

Medical School

Other

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Sheboygan, WI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs +9.5 yrs vs City Avg

City Avg: 12.5 Yrs

State Avg: 14.1 Yrs

Regional Practice Density

43 Specialists

Practicing in Sheboygan, WI (3517 Statewide)

Telehealth Adoption Rate

4.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

82.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. James (22 Years) 22 Yrs

Sheboygan Specialty Average (12.5 Years) 12.5 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	263	239	$515.00	$101.58
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	55	37	$390.00	$60.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	312	280	$490.00	$103.78
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	75	50	$370.00	$62.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	249	234	$465.00	$104.70
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	51	37	$355.00	$56.63
99442 Telephone medical discussion with physician, 11-20 minutes	22	22	$275.00	$73.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	299	274	$435.00	$104.97
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	64	35	$330.00	$58.03
99442 Telephone medical discussion with physician, 11-20 minutes	51	50	$275.00	$74.44
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	20	13	$450.00	$83.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	298	273	$416.00	$88.23
99442 Telephone medical discussion with physician, 11-20 minutes	113	108	$240.00	$61.27
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	63	39	$315.00	$58.64
93793 Anticoagulant management of patient taking warfarin	20	19	$65.00	$9.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	236	206	$380.58	$86.98
93793 Anticoagulant management of patient taking warfarin	103	82	$62.00	$9.81
99213 Established patient office or other outpatient visit, typically 15 minutes	32	32	$170.31	$48.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	77	$130.31	$64.77
99213 Established patient office or other outpatient visit, typically 15 minutes	83	82	$56.94	$42.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	152	140	$56.82	$41.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	75	$129.44	$63.74

Medical Specialties & State Licenses

CMS Verified: 2024-12-02

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WI 1822

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

41998200 (WI)

Commercial Insurance / Payer ID Network Health

14825 (WI)

Commercial Insurance / Payer ID Medicare Railroad

P00192602 (WI)

Hospital & Practice Group Affiliations

Aurora Medical Group, Inc.

3400 Union Ave, Sheboygan, WI 530818426

Phone: 9208282530

Aurora Medical Group, Inc.

1020 N 12th St, Milwaukee, WI 532331308

Phone: 4142193056

Practice Associates & Co-Workers

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

9 Associated Practitioners

Pamela Higgins , NP

Nurse Practitioner

NPI 1053502625

Nurse Practitioner

Dr. George Kuttickat , MD

Internal Medicine - Cardiovascular Disease

NPI 1447367982

Doctor of Medicine (M.D.)

Nicole Mentink , OTR, L

Occupational Therapist

NPI 1770236457

Occupational Therapist Registered, L

Dr. Steven Kream , MD

Internal Medicine - Pulmonary Disease

NPI 1780751974

Doctor of Medicine (M.D.)

Dr. Nebiyu Biru , MD

Internal Medicine - Pulmonary Disease

NPI 1780983320

Doctor of Medicine (M.D.)

Dr. William Ritt , DO

Surgery

NPI 1811283526

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

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

11 Historical Events

📍

Updated Practice Location December 02, 2024

Registered at 3400 UNION AVE, SHEBOYGAN, WI 530818426 (Tel: 9208282700)

📍

Updated Business Mailing Address December 02, 2024

Registered at PO BOX 735044, CHICAGO, IL 606735044 (Tel: 8003262250)

📍

Updated Practice Location April 29, 2019

Registered at 2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 530813129 (Tel: 9204574461)

📍

Updated Business Mailing Address April 29, 2019

Registered at 2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 530813129 (Tel: 9204574461)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2019

Physician Assistant (License #1822 in WI)

✅

NPI Profile Active April 22, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location April 22, 2013

Registered at 1650 S 41ST ST, MANITOWOC, WI 542207316 (Tel: 9203204500)

📍

Updated Business Mailing Address April 22, 2013

Registered at PO BOX 2290, MANITOWOC, WI 542212290 (Tel: 9203202591)

👤

Provider Name / Credentials Updated April 22, 2013

Recorded as HEATHER JAMES, P.A.-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2013

Physician Assistant (License #1822 in WI)

🟢

Initial NPI Registration & Enumeration August 21, 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: 1922114347

Entity Type:

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

Enumeration Date: August 21, 2006

Last Update: December 02, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 735044

Chicago, IL 606735044

Phone: 8003262250

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.