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DR. RYAN THOMAS HERBERT M.D.
NPI 1578880068
Family Medicine in Naperville, IL

Active since April 23, 2010PECOS EnrolledAccepts Medicare Assignment
91.35/100
CMS Quality Rating
2007 95TH ST, NAPERVILLE, IL 60564(630) 527-3200 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 2, 2021, Nov 18, 2020, Nov 13, 2018 (3 updates tracked since 2018).

About Dr. Ryan Thomas Herbert M.d. NPPES

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

DR. RYAN THOMAS HERBERT M.D. (NPI 1578880068) is an individual family medicine provider in Naperville, Illinois, licensed in Illinois (036.133472) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Swedish Hospital, and is a graduate of Rush Medical College Of Rush University (2010).

NPPES Registry Identity

NPI1578880068
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RYAN THOMAS HERBERTCredential: M.D.
Location Address2007 95TH STNaperville, IL 60564-8459
Mailing Address2007 95th StNaperville, IL 60564-8459 · (630) 527-3200 · Fax (630) 527-3201
Phone(630) 527-3200
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2010
Enumeration DateApril 23, 2010
Last NPPES UpdateMarch 2, 20213 updates tracked since enumeration
NPPES CertifiedMarch 2, 2021
✔ NPI 1578880068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IL · 036.133472✔ Licensed in MN · 54132
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2007 95TH ST, Naperville, IL 60564
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Dr. Ryan Thomas Herbert 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 ID1456522697
PECOS Enrollment IDI20201016000690
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

2

Medicare enrollment records show Ryan Herbert reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Edward Health Ventures
Same address
Multi-Specialty
2007 95TH ST, SUITE 105
Naperville, IL 60564
  • Reassigned Medicare billing, Illinois enrollment
  • 561 clinicians in this Medicare group
NPI 1508816547 (630) 646-6920
Endeavor Health Medical Group
36 mi
Allergy & Immunology
1000 CENTRAL ST
Evanston, IL 60201
  • Reassigned Medicare billing, Illinois enrollment
  • 4,841 clinicians in this Medicare group
NPI 1497701882 (847) 570-5235

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 10

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 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.
180 services125 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.
151 services151 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
42 services42 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
40 services40 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.
29 services28 patients
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Swedish Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140114
Location5145 N California AveChicago, IL 60625 · Cook County
Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140231
Location801 South WashingtonNaperville, IL 60540 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60564 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

91.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.71
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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
14 suppliers28 claims84 services$4.87 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers13 claims19 services$0.92 avg. paid by Medicare
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823
DME-Wheelchairs · category DD009N
1 supplier12 claims12 services$130.71 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 15

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

CALLAN MARCUS APN
Nurse Practitioner
2007 95TH ST, SUITE B
NAPERVILLE, IL 60564
Will County (630) 646-6593
DR. PAYAL J PARIKH MD
Family Medicine
2007 95TH ST
NAPERVILLE, IL 60564
Will County (630) 646-6920
MARIA M DAI P.A.
Physician Assistant
2007 95TH ST
NAPERVILLE, IL 60564
Will County (630) 646-6953
EDWARD HOSPITAL IMAGING CENTER BOOK RD
Clinic/Center (Radiology)
2007 95TH ST
NAPERVILLE, IL 60564
Will County (630) 527-3200
JOSEPH A GIORDANO DO
Family Medicine
2007 95TH ST, STE 105
NAPERVILLE, IL 60564
Will County (630) 646-6920
BROOKE DIVINE SCHERER MD
Pediatrics
2007 95TH ST, LL - A CHILDRENS HEALTH PARTNERS, SC
NAPERVILLE, IL 60564
Will County (630) 848-1700
CHRISTINE COLLINS TAYLOR APN-CNP
Nurse Practitioner
2007 95TH ST, SUITE B
NAPERVILLE, IL 60564
Will County (630) 646-6953
MICHELLE LYNN PIERCE MD
Pediatrics
2007 95TH ST, LL A CHILDRENS HEALTH PARTNERS SC
NAPERVILLE, IL 60564
Will County (630) 848-1700

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 Ryan Herbert's NPI number?

The NPI number for Ryan Herbert is 1578880068. It was assigned to this individual provider in the NPPES registry on April 23, 2010.

Where is Ryan Herbert located?

Ryan Herbert practices at 2007 95th St, Naperville, IL 60564. The listed phone number is (630) 527-3200.

What is Ryan Herbert's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ryan Herbert enrolled in Medicare?

Yes. Ryan Herbert 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 Ryan Herbert's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Herbert reassigns Medicare benefits to 2 organizations: Edward Health Ventures (Naperville, IL) and Endeavor Health Medical Group (Evanston, IL). 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 Ryan Herbert's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ryan Herbert accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Ryan Herbert 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 Ryan Herbert affiliated with any hospitals?

According to CMS data, Ryan Herbert is affiliated with Swedish Hospital and Edward Hospital.

When was this NPI record last updated?

The NPPES record for Ryan Herbert was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.