DR. JAMES DOUGLAS BIRMINGHAM (MD) – Rheumatology Physician, NPI 1891811543
Rheumatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,204 PEDIATRIC MEDICINE in MI
Provider Addresses for DR. JAMES DOUGLAS BIRMINGHAM (MD)
5900 BYRON CENTER AVE SW
WYOMING, MI 495199606
Phone: (616) 252-3243
Fax: (616) 252-0260
Type: Mailing
6741 FULTON ST E
ADA, MI 493019502
Phone: (616) 320-5330
Fax: (616) 320-5331
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 279 Open Payments records for all available years, with a total value of $9,997.
Total Amount is formed as General ($9,997) + Research ($0) + Ownership ($0) = $9,997.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($6,189).
Total Amount
$9,997
General + Research + Ownership
Payments
279
Total payment records
General Amount
$9,997
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $6,189 |
| Amgen Inc. | $866 |
| Novartis Pharmaceuticals Corporation | $529 |
| UCB, Inc. | $351 |
| Janssen Biotech, Inc. | $311 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040628000029 | I | Rheumatology | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 106 | 70 | $0 |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 91 | 14 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 39 | 32 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 35 | 35 | $0 |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 20 | 19 | $0 |
Insurance plans in this area (ZIP 49519)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Rheumatology, Internal Medicine | FL | |
| R H E U M A T O L O G Y | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine, Rheumatology | OH | |
| R H E U M A T O L O G Y | WI | |
| R H E U M A T O L O G Y | MI |
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