Karl Herman, M.D.
NPI 1003253063 · Internal Medicine Physician · Providence, RI
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1003253063
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD15316 (RI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
13 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
327 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233 | 146 | $117 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 78 | $171 |
| Hospital Discharge Day Management, More Than 30 Minutes99239 | 74 | $114 |
| Hospital Discharge Day Management, 30 Minutes Or Less99238 | 17 | $81 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 12 | $120 |
Typical Medicare-allowed amounts for these services range $81–$171 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Oxycodone Hcl | 12 | 12 |
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 12 | 12 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-05-31
- Last updated
- 2016-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.