Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHAEL A HERBENICK MD
NPI 1275565020
Orthopaedic Surgery in Centerville, OH

Q: What is Michael Herbenick's NPI number?

The NPI number for Michael Herbenick is 1275565020. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Q: What is Michael Herbenick's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Herbenick was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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.

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment

76.79/100

CMS Quality Rating

2400 MIAMI VALLEY DR STE 160, CENTERVILLE, OH 45459(937) 312-1661(937) 312-1701 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 31, 2016, Dec 30, 2015 (2 updates tracked since 2015).

On this page

About Michael A Herbenick Md NPPES

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

MICHAEL A HERBENICK MD (NPI 1275565020) is an individual orthopaedic surgery provider in Centerville, Ohio, licensed in Ohio (35082289) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and is a graduate of Wright State University Boonshoft School Of Medicine (2000).

NPPES Registry Identity

NPI1275565020

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameMICHAEL A HERBENICKCredential: MD

Location Address2400 MIAMI VALLEY DR STE 160Centerville, OH 45459-4774

Mailing Address3170 Kettering Blvd Bldg B2ndMoraine, OH 45439-1924

Phone(937) 312-1661

Fax(937) 312-1701

Sole ProprietorNo

Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2000

Enumeration DateJuly 6, 2006

Last NPPES UpdateJune 30, 20262 updates tracked since enumeration

NPPES CertifiedJune 30, 2026

✔ NPI 1275565020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in OH · 35082289

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

2400 MIAMI VALLEY DR STE 160, Centerville, OH 45459

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Other Identifiers 1

Medicaid2671078OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael A Herbenick 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 ID143226753

PECOS Enrollment IDI20061004000425

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.

Areas of Expertise CMS Part B claims 14

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.

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

280 services190 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

258 services85 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

145 services117 patients

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.

124 services103 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

113 services81 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.

60 services60 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

41 services41 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

30 services29 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

29 services27 patients

Repair of shoulder rotator cuff using an endoscope 29827

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

27 services27 patients

Removal of extensive shoulder joint tissue using an endoscope 29823

This procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.

24 services24 patients

Release of tendon connecting biceps muscle and shoulder using an endoscope 29828

This procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.

18 services18 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

18 services18 patients

Shaving of part of shoulder bone and repair of ligament using an endoscope 29826

This procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360051

LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County

Emergency services Birthing friendly

Atrium Medical Center

Acute Care Hospitals · Franklin, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360076

LocationOne Medical Center DriveFranklin, OH 45005 · Warren County

Emergency services Birthing friendly

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360174

Location3130 North County Road 25ATroy, OH 45373 · Miami County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45459 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.79/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

64.65

Promoting Interoperability

100

Improvement Activities

Cost

57.98

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

49%135 patients2/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

65%195 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

33%206 patients2/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

60%83 patients3/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

1 supplier24 claims24 services$86.27 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 6

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

JENNIFER RODRIGUEZ FOSTER PA-C

Physician Assistant