Physician

James Frederick Zumstein, MD

According to 2025 Medicare claims, James Zumstein, MD (NPI: 1588778591) practices family practice in the Columbus, GA-AL market, with the plurality of this provider's patient population coming from Russell, AL. This provider's primary affiliated billing organization is JAMES F ZUMSTEIN MD LLC (NPI: 1013021021; TIN: 421588073) and primary practice location at 36867-3179. Zumstein is affiliated with the Piedmont Clinic ACO LLC (ACO ID: A3250), participating under the MSSP model.

Zumstein's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 795 traditional Medicare patients, billed 3,392 HCPCS/CPT codes, and received $184,640 in Medicare payments. The top billing code was 99222 (Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes). Part D data shows 10,843 prescription claims across 617 beneficiaries totaling $1,088,478 in drug costs, led by Eliquis (Apixaban). DME data shows 693 claims. Open Payments data shows 2 records totaling $41. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has declined steadily, from $291,634 to $184,640. Concurrently, Part D prescription costs have changed little. In contrast, DME billing represents a smaller volume and changed little.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	845	8,151	$291,634
2016	725	6,712	$233,750
2017	650	5,872	$220,576
2018	683	5,977	$228,752
2019	727	5,304	$224,988
2020	676	4,070	$182,106
2021	739	4,212	$192,718
2022	693	3,671	$180,696
2023	777	3,401	$176,814
2024	795	3,392	$184,640

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	669	18,616	$1,182,534
2016	519	18,515	$1,161,756
2017	529	17,288	$1,026,184
2018	526	17,446	$1,064,618
2019	557	17,057	$1,162,065
2020	549	16,231	$1,096,048
2021	543	14,765	$1,142,343
2022	562	15,671	$1,295,856
2023	607	14,011	$1,321,801
2024	617	10,843	$1,088,478

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	244	1,103	$42,994
2016	210	1,255	$45,787
2017	133	1,109	$45,236
2018	157	1,081	$53,888
2019	206	1,338	$68,539
2020	115	1,105	$66,104
2021	67	686	$44,924
2022	62	755	$45,791
2023	82	691	$70,362
2024	74	693	$76,881

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	496	527	$97
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	270	861	$82
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	326	581	$59
90661	Influenza vaccine, trivalent derived from cell cultures	95	95	$35
G0008	Administration of influenza virus vaccine	96	96	$29

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	207	8,265	$161,662
Januvia	Sitagliptin Phosphate	123	6,630	$121,315
Ozempic	Semaglutide	105	4,046	$113,045
Xarelto	Rivaroxaban	50	2,762	$50,575
Tresiba Flextouch U-200	Insulin Degludec	57	3,306	$40,621

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
B4197	Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix	N	N/R	17	$38,275
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	34	243	$16,484
B4185	Parenteral nutrition solution, not otherwise specified, 10 grams lipids	N	N/R	19	$4,861
B4224	Parenteral nutrition administration kit, per day	N	N/R	18	$3,633
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	N	N/R	13	$1,995

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	2	$41	Mirum Pharmaceuticals, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for James Frederick Zumstein, MD?

Tedicare shows public-source Medicare data for James Frederick Zumstein, MD (NPI 1588778591), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does James Frederick Zumstein, MD have ACO affiliation data?

James Frederick Zumstein, MD is shown with ACO affiliation data for Piedmont Clinic ACO LLC (MSSP, ACO ID A3250).

What billing organization is linked to James Frederick Zumstein, MD?

James Frederick Zumstein, MD is linked to JAMES F ZUMSTEIN MD LLC (billing NPI 1013021021) in the available physician profile data.

Does James Frederick Zumstein, MD have Open Payments data?

James Frederick Zumstein, MD has 2 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.