DOUGLAS JAMES HERBEK MD
NPI 1861492803
Family Medicine in Grand Island, NE

Active since July 29, 2005PECOS Enrolled
2444 W FAIDLEY AVE, GRAND ISLAND, NE 68803(308) 382-1100(308) 385-0796 Get Directions Write a Review

NPPES record last updated: November 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Douglas James Herbek Md NPPES

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

DOUGLAS JAMES HERBEK MD (NPI 1861492803) is an individual family medicine provider in Grand Island, Nebraska, licensed in Nebraska (21677) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Chi Health St. Francis, and is a graduate of University Of Nebraska College Of Medicine (1998).

NPPES Registry Identity

NPI1861492803
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDOUGLAS JAMES HERBEKCredential: MD
Location Address2444 W FAIDLEY AVEGrand Island, NE 68803-4327
Mailing AddressPo Box 550Grand Island, NE 68802-0550 · (308) 382-1100 · Fax (308) 385-0796
Fax(308) 385-0796
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 1998
Enumeration DateJuly 29, 2005
Last NPPES UpdateNovember 10, 2023
NPPES CertifiedNovember 10, 2023
NPI 1861492803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NE · 21677
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.
2444 W FAIDLEY AVE, Grand Island, NE 68803

Other Identifiers 4

Other35339NE · Bcbs
Medicaid47017633012NE
Other232229NE · Midlands Choice
Other80170907NE · Palmetto Gba

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 (PECOS)

Douglas James Herbek Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365547106
PECOS Enrollment IDI20100201000718
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 41

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
327 services172 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027
A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
306 services164 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
303 services168 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
243 services163 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
234 services156 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.
216 services111 patients

Hospital Affiliations CMS Care Compare 2

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

Chi Health St. Francis

Acute Care Hospitals · Grand Island, NE
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number280023
Location2620 West Faidley AveGrand Island, NE 68803 · Hall County
Emergency services Birthing friendly

Grand Island Regional Medical Center

Acute Care Hospitals · Grand Island, NE
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number280139
Location3533 Prairieview StreetGrand Island, NE 68803 · Hall County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68803 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
$81.20 typical visit price
range $52.69 – $160.21
Typical copayment $20.30 (range $13.17 – $40.05)
Most-billed visit code 99203
Established Patient
$93.55 typical visit price
range $16.90 – $131.25
Typical copayment $23.38 (range $4.22 – $32.81)
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.

Reported Quality Measures

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…
100%156 patients5/55-star benchmark: 100%
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 16

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
11 suppliers51 claims75 services$5.80 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers12 claims13 services$1.04 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers19 claims19 services$38.52 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers19 claims19 services$94.92 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers19 claims57 services$34.63 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers17 claims17 services$49.97 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 20

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

Clinical Medical Laboratory
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Pediatrics
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Obstetrics & Gynecology
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Obstetrics & Gynecology (Obstetrics)
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Family Medicine
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Family Medicine
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Physician Assistant
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803
Obstetrics & Gynecology
2444 W FAIDLEY AVE
GRAND ISLAND, NE 68803

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 Herbek's NPI number?

The NPI number for Douglas Herbek is 1861492803. It was assigned to this individual provider in the NPPES registry on July 29, 2005.

Where is Douglas Herbek located?

Douglas Herbek practices at 2444 W Faidley Ave, Grand Island, NE 68803. The listed phone number is (308) 382-1100.

What is Douglas Herbek's specialty?

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

Is Douglas Herbek enrolled in Medicare?

Yes. Douglas Herbek is registered in the Medicare PECOS enrollment system.

What insurance does Douglas Herbek accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list Douglas Herbek 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 Herbek affiliated with any hospitals?

According to CMS data, Douglas Herbek is affiliated with Chi Health St. Francis and Grand Island Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Douglas Herbek was last updated on November 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.