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    OpenPayerNPI Medicare & MedicaidJames Sutton
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    James Sutton — Billing Profile & Reimbursement Data

    NPI 1356995708 · Waxahachie, TX · Family Nurse Practitioner

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    James Sutton is a family nurse practitioner provider located in Waxahachie, Texas. This profile covers 19 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Sutton
    Address905 Ferris Ave
    CityWaxahachie
    StateTX
    ZIP75165
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedJuly 24, 2019

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$71.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    0101TThe provider applies a shock wave to treat a painful musculoskeletal area at a location other than those identified by another CPT® code.180$200$35.8K
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…590$20$8.8K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…110$60$6K
    97112Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…250$20$5.2K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…40$80$3.1K
    97032Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…250$10$2K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…30$60$1.7K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…40$40$1.5K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…10$90$1.1K
    72100The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…40$20$850

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    0101T210160$200$61.6K
    9921425,40832,500110$80$17.6K
    971102,1693,610450$20$14K
    971121,6402,900300$20$10.8K
    9921313,03429,79070$60$8.4K
    9920417,78416,38030$110$5.6K
    971243930100$20$4.5K
    364155,0626,270100$10$4.5K
    992037,12410,82030$70$3.4K
    G0283486560190$10$2.5K

    Showing 1–10 of 19

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with James Sutton, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wing Yi LiuFLCardiovascular Disease Physician$1.6M$0
    Ravi RaoFLCardiovascular Disease Physician$1.6M$0
    Prabhakara KunamneniFLCardiovascular Disease Physician$1.4M$0
    Dinesh ArabFLCardiovascular Disease Physician$1.3M$0
    Huijian WangFLCardiovascular Disease Physician$1.3M$0
    Ratan AhujaFLCardiovascular Disease Physician$1M$0
    Ahmad ShamsinFLCardiovascular Disease Physician$984.1K$0
    Laeeq ButtVAInternal Medicine Physician$942.5K$0
    Nathaniel ValinFLCardiovascular Disease Physician$703.2K$0
    Ashraf ElsakrFLInterventional Cardiology Physician$504.1K$0

    Nearby Providers

    Other providers in the same ZIP code as James Sutton, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tao HoTXInternal Medicine Physician$4.2M$0
    Andrew WordTXDermatology Physician$556.8K$0
    Amir KhanTXPulmonary Disease Physician$511.9K$0
    Amy EdwardsTXPhysician Assistant$329.7K$0
    Shahram KhalidTXNeurology Physician$258.8K$0
    Francis NwaforTXUrology Physician$179.1K$0
    David ScheidTXInternal Medicine Physician$176.6K$0
    Danica WatsonTXPhysical Therapist$156.7K$0
    Sharon ChoiTXCardiovascular Disease Physician$155.6K$0
    Wenbao WangTXPain Medicine (Physical Medicine & Rehabilitation) Physician$117.4K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Texas Distribution
    James Sutton — 0 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas