JAMES G. HERMAN M.D.
NPI 1750311973
Radiology - Radiation Oncology in Lansing, MI
NPI Status: Active since July 04, 2006
Contact Information
1215 E MICHIGAN AVE
LANSING, MI
ZIP 48912
Phone: (269) 567-9835
Fax: (269) 567-9841
- Individual
- Male
- Radiology
- Radiation Oncology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About JAMES HERMAN
This page provides the complete NPI Profile along with additional information for James Herman, a provider established in Lansing, Michigan with a medical specialization in Radiology, focusing in radiation oncology . The healthcare provider is registered in the NPI registry with number 1750311973 assigned on July 2006. The practitioner's primary taxonomy code is 2085R0001X with license number 4301046476 (MI). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1750311973
- Provider Name
- JAMES G. HERMAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1215 E MICHIGAN AVE LANSING, MI 48912
- Location Phone
- (269) 567-9835
- Location Fax
- (269) 567-9841
- Mailing Address
- 6411 PINE HOLLOW DR EAST LANSING, MI 48823
- Mailing Phone
- (269) 567-9835
- Mailing Fax
- (269) 567-9841
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-04-2006
- Last Update Date
- 11-26-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Radiation Oncology
- Taxonomy Code
- 2085R0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301046476
- License State
- MI
- Taxonomy Description
- A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- MyPriority Balanced Silver - HMO
- MyPriority Premier Silver - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Silver - HMO
- MyPriority Standard Silver - Travel - HMO
- MyPriority Value Bronze - HMO
- MyPriority Value Bronze HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 320G410340 | OTHER (01) | MI | BCBS GROUP PIN |
Medicare Participation & PECOS Enrollment Status
James Herman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
3d radiation therapy planning
Calculation of radiation therapy dose
Complex radiation therapy planning
Complex radiation therapy planning for delivery of external radiation
Design and construction of complex radiation treatment device
Design and construction of intermediate radiation treatment device
Design and construction of radiation treatment device for high precision radiation therapy
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 40-54 minutes
High precision radiation therapy planning
Management of cranial lesion surgery using radiation over multiple sessions
New patient office or other outpatient visit, 60-74 minutes
Obtaining data needed to develop the optimal radiation treatment, 1 treatment area
Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved
Radiation treatment management, 5 treatment sessions
Special radiation therapy planning
Special radiation treatment
3D radiation therapy planning is a procedure that uses computer imaging to map out the area needing treatment. This ensures the radiation targets the disease precisely, while minimizing exposure to surrounding healthy tissues. It's a key step in preparing for effective radiation therapy.
This service was performed 82 times for 62 patientsRadiation therapy dose calculation is a process to determine the exact amount of radiation needed to treat a specific area in the body. This calculation helps ensure the treatment is effective while minimizing harm to healthy tissues. It's a key part of planning your radiation therapy.
This service was performed 92 times for 41 patientsComplex radiation therapy planning is a process to determine the most effective way to deliver radiation to a specific area in your body. It involves detailed imaging to map your body's structure, allowing for precise targeting of cancer cells while sparing healthy tissue.
This service was performed 79 times for 54 patientsComplex radiation therapy planning involves creating a detailed plan to deliver targeted radiation doses. The process includes imaging scans to identify the area needing treatment, and designing a specific radiation plan to protect healthy tissue while effectively treating the disease.
This service was performed 199 times for 73 patientsThe design and construction of a complex radiation treatment device is a process where a specialized instrument is created. This device targets harmful cells with high-energy rays to destroy or damage them, while minimizing impact on healthy cells. This aids in treating conditions like cancer.
This service was performed 286 times for 68 patientsThe design and construction of an intermediate radiation treatment device is a process where a custom device is made to help deliver radiation therapy. This device is designed to focus radiation beams precisely on the area needing treatment, minimizing exposure to surrounding healthy tissues.
This service was performed 50 times for 49 patientsA radiation treatment device is custom-made for each patient to target cancer cells with high precision. It's designed to focus radiation on the tumor, sparing healthy tissue. This process ensures effective therapy while minimizing side effects.
This service was performed 54 times for 35 patientsThis 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.
This service was performed 151 times for 129 patientsThis 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.
This service was performed 21 times for 21 patientsHigh precision radiation therapy planning involves detailed mapping of your body to target cancer cells accurately. Advanced imaging techniques help identify the exact location of the tumor, minimizing harm to healthy tissues. This personalized approach enhances effectiveness and reduces side effects.
This service was performed 34 times for 33 patientsThis procedure involves using targeted radiation to treat a lesion in the brain over several sessions. The radiation destroys the abnormal cells, helping to control or eliminate the lesion. It's a non-invasive treatment, meaning no surgical cuts are made.
This service was performed 66 times for 14 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 78 times for 78 patientsThis procedure involves gathering essential information to create the best radiation treatment plan for a specific area. It includes scanning the treatment area and using this data to calculate the precise dose of radiation needed to target the disease effectively, while sparing healthy tissue.
This service was performed 125 times for 73 patientsThis procedure involves collecting necessary data to plan the best radiation treatment. It may cover 3 or more areas or any area requiring special attention. Data collection includes imaging scans and tests to understand the disease's extent and to tailor a precise, effective treatment plan.
This service was performed 108 times for 71 patientsRadiation treatment management involves a series of 5 sessions where targeted radiation is used to destroy or shrink cancer cells in your body. Each session is carefully planned to maximize effectiveness while minimizing harm to healthy tissues. You may experience side effects which will be closely monitored and managed for your comfort.
This service was performed 239 times for 61 patientsSpecial radiation therapy planning is a process to determine the most effective way to deliver radiation treatment. It involves imaging studies to map your body's internal structure, which helps in targeting the exact area needing treatment while sparing healthy tissues.
This service was performed 603 times for 75 patientsSpecial radiation treatment is a medical procedure that uses high-energy rays to destroy or damage cancer cells. It's a targeted approach that aims to minimize harm to healthy tissues. The treatment duration varies based on individual health conditions.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 48912 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $166.68
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.68
- Average New Patient Copayment $41.67
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.67
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.07
- Minimum Established Patient Price $17.09
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $17.01
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 88% | 617 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Care coordination agreements that promote improvements in patient tracking across settings | Yes | N/A |
| Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 2% | 287 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Colorectal Cancer Screening | 56% | 758 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Foot Exam | 34% | 126 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| Diabetes: Medical Attention for Nephropathy | 90% | 126 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Documentation of Current Medications in the Medical Record | 97% | 1745 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| Falls: Screening for Future Fall Risk | 30% | 575 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Health Information Exchange | 46% | 61 |
| 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 at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Improved Practices that Disseminate Appropriate Self-Management Materials | Yes | N/A |
| Provide self-management materials at an appropriate literacy level and in an appropriate language. | ||
| Medication Reconciliation | 97% | 802 |
| 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. | ||
| Patient-Specific Education | 81% | 1174 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 36% | 577 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 46% | 1126 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 28% | 878 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 4% | 957 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 50% | 20 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 100% | 1174 |
| 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 certain information. | ||
| Secure Messaging | 28% | 1174 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
| Use of High-Risk Medications in the Elderly | 0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 577 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1750311973, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LANSING, MI 48912
LANSING, MI 48912
LANSING, MI 48912
LANSING, MI 48912
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750311973, enumerated as an "individual" on July 04, 2006.
The provider is located at 1215 E MICHIGAN AVE LANSING, MI 48912 and the phone number is (269) 567-9835.
Radiology with taxonomy code 2085R0001X and a focus in Radiation Oncology.
The provider might be accepting Accepts: Priority Health, Blue Cross Blue Shield, Medicare. Please consult your insurance carrier or call the provider to verify.
