DOUGLAS JAMES HERBEK MD
NPI 1861492803
Family Medicine in Grand Island, NE
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
Specialties & Licenses
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Douglas James Herbek Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Douglas Herbek reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Island, NE 68803
- Reassigned Medicare billing, Nebraska enrollment
- 30 clinicians in this Medicare group
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 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.
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, NEGrand Island Regional Medical Center
Acute Care Hospitals · Grand Island, NEPhysician 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.
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
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.
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.
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.
Which organization bills Medicare for Douglas Herbek's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Herbek reassigns Medicare benefits to Grand Island Clinic Inc (Grand Island, NE). The 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 Douglas Herbek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Douglas Herbek accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Blue Cross and Blue Shield of Nebraska and Oscar Insurance Company and 1 other insurer 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.