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JAMES J. HERDEGEN MD
NPI 1184737793
Internal Medicine in Chicago, IL

Active since August 16, 2006PECOS EnrolledAccepts Medicare Assignment
1740 W TAYLOR ST, CHICAGO, IL 60612(866) 600-2273 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About James J. Herdegen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES J. HERDEGEN MD (NPI 1184737793) is an individual internal medicine provider in Chicago, Illinois, licensed in Illinois (036078423) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1184737793
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJAMES J. HERDEGENCredential: MD
Location Address1740 W TAYLOR STChicago, IL 60612-7232
Mailing Address840 S Wood St, 806 Csb, Mc 719Chicago, IL 60612-4325 · (312) 413-9036 · Fax (312) 996-4665
Phone(866) 600-2273
Sole ProprietorNo
Medical School CMSUniversity Of Chicago, Pritzker School Of MedicineGraduated 1986
Enumeration DateAugust 16, 2006
Last NPPES UpdateJuly 29, 2025
NPPES CertifiedJuly 29, 2025
✔ NPI 1184737793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036078423
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 75092 (WI)
1740 W TAYLOR ST, Chicago, IL 60612
Open in Google Maps ↗

Secondary Practice Locations 2

Location 114555 W National AveNew Berlin, WI 53151-4494 · Phone (844) 284-0381
Location 29555 S 52nd AveOak Lawn, IL 60453-3054 · Phone (708) 634-0950 · Fax (708) 634-0942

Other Identifiers 5

Other0040154978IL · Bcbs Provider #
Other0081644641IL · Bcbs Provider #
Other0001633166IL · Bcbs Provider #
Medicaid1003255818WI
Other0021647388IL · Bcbs Provider #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James J. Herdegen Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143212779
PECOS Enrollment IDI20040401001384
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show James Herdegen reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Board Of Trustees Of The University Of Illinois
Same address
Anesthesiology
1740 W TAYLOR ST
Chicago, IL 60612
  • Reassigned Medicare billing, Illinois enrollment
  • 2,127 clinicians in this Medicare group
NPI 1013136282 (312) 996-4020
Rush University Medical Group
0.4 mi
Internal Medicine
1620 W HARRISON ST
Chicago, IL 60612
  • Reassigned Medicare billing, Illinois enrollment
  • 2,169 clinicians in this Medicare group
NPI 1093819542 (312) 942-5000
Advocate Health & Hospitals Corp.
2.2 mi
Emergency Medicine
3435 W VAN BUREN ST
Chicago, IL 60624
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Advocate Health And Hospitals Corporation
  • 4,870 clinicians in this Medicare group
NPI 1750315545 (773) 265-3583
Aurora Medical Group, Inc.
79 mi
Nurse Anesthetist, Certified Registered
3301 W FOREST HOME AVE
Milwaukee, WI 53215
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
NPI 1427271378 (877) 576-3544

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
123 services105 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
82 services82 patients
Sleep study including heart rate, breathing, and sleep time 95800
A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
53 services52 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
46 services46 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
36 services36 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
34 services33 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140010
Location2650 Ridge AveEvanston, IL 60201 · Cook County
Emergency services Birthing friendly

Rush Oak Park Hospital

Acute Care Hospitals · Oak Park, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140063
Location520 S Maple AveOak Park, IL 60304 · Cook County
Emergency services

Rush University Medical Center

Acute Care Hospitals · Chicago, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140119
Location1653 West Congress ParkwayChicago, IL 60612 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 21

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
21 suppliers893 claims893 services$33.51 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
19 suppliers505 claims505 services$72.13 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
18 suppliers492 claims1,428 services$27.58 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
16 suppliers281 claims1,657 services$15.25 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
9 suppliers190 claims1,040 services$12.48 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
19 suppliers515 claims515 services$46.12 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CATHLEEN CONWAY JENSEN OTR/L
Occupational Therapist
1740 W TAYLOR ST, C100
CHICAGO, IL 60612
Cook County (312) 996-3700
KELLY M HOYERT PA-C
Physician Assistant (Surgical)
1740 W TAYLOR ST, 3F OCC
CHICAGO, IL 60612
Cook County (312) 355-4300
DR. YI-LOONG COLIN WOON M.D.
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (866) 600-2273
VIDHI SRIVASTAVA MD
Anesthesiology
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (866) 600-2273
AMY PHAM D.O.
Pediatrics (Neonatal-Perinatal Medicine)
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (866) 600-2273
WILSON CHING M.D.
Family Medicine
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (866) 600-2273
ADRIENNE BERMAN MD
Ophthalmology
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (866) 600-2273
JOSEPH S COLLA M.D.
Emergency Medicine
1740 W TAYLOR ST
CHICAGO, IL 60612
Cook County (312) 996-8177

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Herdegen's NPI number?

The NPI number for James Herdegen is 1184737793. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Where is James Herdegen located?

James Herdegen practices at 1740 W Taylor St, Chicago, IL 60612. The listed phone number is (866) 600-2273.

What is James Herdegen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Herdegen enrolled in Medicare?

Yes. James Herdegen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for James Herdegen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Herdegen reassigns Medicare benefits to 4 organizations: Board Of Trustees Of The University Of Illinois (Chicago, IL), Rush University Medical Group (Chicago, IL), Advocate Health & Hospitals Corp. (Chicago, IL) and Aurora Medical Group, Inc. (Milwaukee, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Herdegen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Herdegen accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and CareSource (Common Ground Healthcare) list James Herdegen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Herdegen affiliated with any hospitals?

According to CMS data, James Herdegen is affiliated with Northshore University Healthsystem - Evanston Hospital, Rush Oak Park Hospital and Rush University Medical Center.

When was this NPI record last updated?

The NPPES record for James Herdegen was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.