GUILLERMO A HERRERA MD
NPI 1558375220
Pathology - Anatomic Pathology & Clinical Pathology in Mobile, AL

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
96.56/100
CMS Quality Rating
2451 UNIVERSITY HOSPITAL DR FL 1, MOBILE, AL 36617(251) 471-7790(251) 471-7096 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Guillermo A Herrera Md NPPES

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

GUILLERMO A HERRERA MD (NPI 1558375220) is an individual anatomic pathology & clinical pathology provider in Mobile, Alabama, licensed in Alabama (MD.10166) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Jupiter Medical Center, and is a graduate of University Of Puerto Rico School Of Medicine (1975).

NPPES Registry Identity

NPI1558375220
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameGUILLERMO A HERRERACredential: MD
Location Address2451 UNIVERSITY HOSPITAL DR FL 1Mobile, AL 36617-2300
Mailing AddressPo Box 40480Mobile, AL 36640-0480 · (251) 434-3626 · Fax (251) 445-2464
Fax(251) 471-7096
Sole ProprietorNo
Medical School CMSUniversity Of Puerto Rico School Of MedicineGraduated 1975
Enumeration DateJuly 28, 2006
Last NPPES UpdateJanuary 20, 2021
NPPES CertifiedJanuary 20, 2021
NPI 1558375220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Licenses Licensed in AL · MD.10166 Licensed in MO · 2006000543 Licensed in LA · 11552R
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
2451 UNIVERSITY HOSPITAL DR FL 1, Mobile, AL 36617

Accepted 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

Guillermo A Herrera 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 ID42226979
PECOS Enrollment IDI20190107000923
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 5

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.

Antibody evaluation, each additional single antibody stain procedure 88350
An antibody evaluation involves testing a sample of your body fluid (like blood) to identify specific antibodies. Each additional single antibody stain procedure is a separate test for another specific antibody. This helps in diagnosing various health conditions by understanding your body's immune response.
235 services29 patients
Special stained specimen slides to examine tissue including interpretation and report 88313
Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.
88 services29 patients
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
42 services36 patients
Antibody evaluation, initial single antibody stain procedure 88346
An antibody evaluation, initial single antibody stain procedure is a laboratory test. It's designed to identify specific proteins, or antibodies, in your body. This can help diagnose certain conditions or monitor your immune system's response to treatments. The procedure involves staining a single type of antibody for detection.
29 services29 patients
Electron microscopy for diagnosis 88348
Electron microscopy is a diagnostic tool providing detailed images of tiny structures within the body, much smaller than those visible with regular microscopes. It aids in identifying diseases at a cellular level, enhancing accuracy of diagnosis.
27 services27 patients

Hospital Affiliations CMS Care Compare 3

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

Jupiter Medical Center

Acute Care Hospitals · Jupiter, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100253
Location1210 S Old Dixie HwyJupiter, FL 33458 · Palm Beach County
Emergency services Birthing friendly

Good Samaritan Medical Center

Acute Care Hospitals · West Palm Beach, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100287
Location1309 N Flagler DrWest Palm Beach, FL 33401 · Palm Beach County
Emergency services Birthing friendly

Medstar Saint Mary's Hospital

Acute Care Hospitals · Leonardtown, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210028
Location25500 Point Lookout RoadLeonardtown, MD 20650 · St. Marys County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36617 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

96.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality89.76
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 10

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

Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Anatomic Pathology & Clinical Pathology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617
Pathology (Hematology)
2451 UNIVERSITY HOSPITAL DR FL 1
MOBILE, AL 36617

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 Guillermo Herrera's NPI number?

The NPI number for Guillermo Herrera is 1558375220. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Guillermo Herrera located?

Guillermo Herrera practices at 2451 University Hospital Dr Fl 1, Mobile, AL 36617. The listed phone number is (251) 471-7790.

What is Guillermo Herrera's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Guillermo Herrera enrolled in Medicare?

Yes. Guillermo Herrera 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 Guillermo Herrera accept?

Health plans from Blue Cross and Blue Shield of Alabama, Molina Healthcare and Oscar Health Plan, Inc. list Guillermo Herrera 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 Guillermo Herrera affiliated with any hospitals?

According to CMS data, Guillermo Herrera is affiliated with Jupiter Medical Center, Good Samaritan Medical Center and Medstar Saint Mary's Hospital.

When was this NPI record last updated?

The NPPES record for Guillermo Herrera was last updated on January 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.