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DR. DOUGLAS GREGORY HAMES M.D.
NPI 1457400954
Internal Medicine in Eastpointe, MI

Active since January 10, 2007PECOS EnrolledAccepts Medicare Assignment
86.85/100
CMS Quality Rating
22850 KELLY RD, EASTPOINTE, MI 48021(586) 774-2900 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Douglas Gregory Hames M.d. NPPES

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

DR. DOUGLAS GREGORY HAMES M.D. (NPI 1457400954) is an individual internal medicine provider in Eastpointe, Michigan, licensed in Michigan (DH040884) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and is a graduate of Wayne State University School Of Medicine (1976).

NPPES Registry Identity

NPI1457400954
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. DOUGLAS GREGORY HAMESCredential: M.D.
Location Address22850 KELLY RDEastpointe, MI 48021-2028
Mailing Address1225 Sunningdale DrGrosse Pointe Woods, MI 48236-1672 · (313) 882-6611
Phone(586) 774-2900
Sole ProprietorYes
Medical School CMSWayne State University School Of MedicineGraduated 1976
Enumeration DateJanuary 10, 2007
Last NPPES UpdateJuly 11, 2023
NPPES CertifiedJuly 11, 2023
✔ NPI 1457400954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · DH040884
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.
22850 KELLY RD, Eastpointe, MI 48021
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Other Identifiers 4

Other0503285MI · Bcbs
Medicaid2101011MI
Other4301040884MI · Bc
Other040884MI · Private Ins

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Dr. Douglas Gregory Hames M.d. 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 ID4880721810
PECOS Enrollment IDI20100423000265
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 6

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.
110 services69 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
70 services70 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.
68 services52 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
45 services45 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
28 services26 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
12 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230195
Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48021 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

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.

86.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.71
Promoting Interoperability100
Improvement Activities40
Cost65.3

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
75%214 patients4/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
48%193 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
74%507 patients4/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 44% · 78 patients
Patients 4MonthsOfStart: 81% · 53 patients
49%65 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
51%148 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%11,308 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
70%778 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%154 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
58%938 patients3/55-star benchmark: 97%
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…
41%945 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
93%938 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
11%938 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
28%938 patients
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 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
17 suppliers43 claims132 services$5.59 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers17 claims21 services$0.78 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers17 claims34 services$0.92 avg. paid by Medicare
Small volume nonfiltered pneumatic nebulizer, disposable A7004
DME-Other DME · category DE000N
1 supplier12 claims24 services$0.92 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers18 claims5,349 services$0.03 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers27 claims27 services$20.74 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

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

DOUGLAS G HAMES MD PLLC
Internal Medicine
22850 KELLY RD
EASTPOINTE, MI 48021
Macomb County (586) 774-2900

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 Douglas Hames's NPI number?

The NPI number for Douglas Hames is 1457400954. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Where is Douglas Hames located?

Douglas Hames practices at 22850 Kelly Rd, Eastpointe, MI 48021. The listed phone number is (586) 774-2900.

What is Douglas Hames's specialty?

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

Is Douglas Hames enrolled in Medicare?

Yes. Douglas Hames 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.

What insurance does Douglas Hames accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Douglas Hames 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 Douglas Hames affiliated with any hospitals?

According to CMS data, Douglas Hames is affiliated with Henry Ford Health Hospital, Beaumont Hospital - Grosse Pointe, Beaumont Hospital Royal Oak, Ascension St John Hospital and Ascension Macomb Oakland Hosp-Warren Campus.

When was this NPI record last updated?

The NPPES record for Douglas Hames was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.