DR. JAMES PATRICK HERLIHY M.D.
NPI 1972555449
Internal Medicine - Critical Care Medicine in Houston, TX

Q: What is James Herlihy's NPI number?

The NPI number for James Herlihy is 1972555449. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Q: What is James Herlihy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for James Herlihy was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment

91.34/100

CMS Quality Rating

6624 FANNIN ST, SUITE 1730, HOUSTON, TX 77030(713) 255-4000(713) 255-4050 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. James Patrick Herlihy M.d. NPPES

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

DR. JAMES PATRICK HERLIHY M.D. (NPI 1972555449) is an individual critical care medicine provider in Houston, Texas, licensed in Texas (J8269) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Chi St Luke's Health Baylor College Of Medicine Me, and is a graduate of Georgetown University School Of Medicine (1984).

NPPES Registry Identity

NPI1972555449

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDR. JAMES PATRICK HERLIHYCredential: M.D.

Location Address6624 FANNIN ST, SUITE 1730Houston, TX 77030-2312

Mailing AddressDept 794, Po Box 4346Houston, TX 77210-4346 · (713) 255-4000 · Fax (713) 255-4050

Phone(713) 255-4000

Fax(713) 255-4050

Sole ProprietorNo

Medical School CMSGeorgetown University School Of MedicineGraduated 1984

Enumeration DateMay 16, 2006

Last NPPES UpdateAugust 31, 2021

NPPES CertifiedAugust 31, 2021

✔ NPI 1972555449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in TX · J8269

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License J8269 (TX)

6624 FANNIN ST, Houston, TX 77030

Open in Google Maps ↗

Other Identifiers 4

Medicaid039337302TX

OtherP00184432TX · Railroad Medicare #

Other8R1143TX · Blue Cross Prov #

Other5435057TX · Aetna Prov #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice, WellPoint.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

Dr. James Patrick Herlihy 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 ID648245050

PECOS Enrollment IDI20040830000580

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 3

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

123 services46 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

60 services38 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Chi St Luke's Health Baylor College Of Medicine Me

Acute Care Hospitals · Houston, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450193

Location6720 Bertner Ave, Ste Mc1-266Houston, TX 77030 · Harris County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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

$134.06 typical visit price

range $58.24 – $176.98

Typical copayment $33.51 (range $14.56 – $44.24)

Most-billed visit code 99204

Established Patient

$102.71 typical visit price

range $18.60 – $143.93

Typical copayment $25.67 (range $4.65 – $35.98)

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.

91.34/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.64

Promoting Interoperability

89.13

Improvement Activities

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.

DR. JAIME BENREY MD

Internal Medicine (Cardiovascular Disease)

6624 FANNIN ST, STE 2310
HOUSTON, TX 77030

Harris County (713) 796-2668

MARISOL J SKIBIN P.T.

Physical Therapist

6624 FANNIN ST, SUITE 2600
HOUSTON, TX 77030

Harris County (713) 790-1818

MELANIE EHNI MOUZOON MD

Pediatrics

6624 FANNIN ST
HOUSTON, TX 77030

Harris County (713) 442-0000

SAMAR SHETH MD

Internal Medicine (Cardiovascular Disease)

6624 FANNIN ST, SUITE 2320
HOUSTON, TX 77030

Harris County (832) 355-6676

FRANK TRAVIS GEROW M.D.

Orthopaedic Surgery (Pediatric Orthopaedic Surgery)

6624 FANNIN ST, SUITE 2600
HOUSTON, TX 77030

Harris County (713) 790-1818

DAWN DENISE SHORT CNM

Advanced Practice Midwife

6624 FANNIN ST, SUITE 1800
HOUSTON, TX 77030

Harris County (713) 797-1144

HOUSTON HEART CLINIC

Internal Medicine (Cardiovascular Disease)

6624 FANNIN ST, STE. 1590
HOUSTON, TX 77030

Harris County (713) 759-9901

SUSHANTH BEERAVOLU REDDY DO

Hospitalist

6624 FANNIN ST
HOUSTON, TX 77030

Harris County (713) 442-0427

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 James Herlihy's NPI number?

The NPI number for James Herlihy is 1972555449. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is James Herlihy located?

James Herlihy practices at 6624 Fannin St Suite 1730, Houston, TX 77030. The listed phone number is (713) 255-4000.

What is James Herlihy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is James Herlihy enrolled in Medicare?

Yes. James Herlihy 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 James Herlihy accept?

Health plans from Blue Cross and Blue Shield of Texas, Community Health Choice and WellPoint list James Herlihy 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 James Herlihy affiliated with any hospitals?

According to CMS data, James Herlihy is affiliated with Chi St Luke's Health Baylor College Of Medicine Me.

When was this NPI record last updated?

The NPPES record for James Herlihy was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.