KARL HERMAN (M.D.) – Internal Medicine Physician, NPI 1003253063

KARL HERMAN (M.D.) is a healthcare provider. based in Providence, Rhode Island. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD15316 (RI). The NPI Number for KARL HERMAN (M.D.) is 1003253063

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
KARL HERMAN (M.D.)
NPI
1003253063
Phone
(401) 793-4489
Address
164 SUMMIT AVE
Enumeration Date
31 May 2013
Last Update Date
10 June 2016

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
4017939166
Graduation Year
2013 (13 years ago)
PAC ID
0840417259
Group Practice PAC ID
2567455082
Professional Enrollment ID
I20160803000113
Address ID
RI029034923PR593XXFLOO700
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,158 INTERNAL MEDICINE in RI

Provider Addresses for KARL HERMAN (M.D.)

  • 164 SUMMIT AVE

    FAIN BLDG.

    PROVIDENCE, RI 029062853

    Phone: (401) 793-4489

    Fax: (401) 793-4047

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160803000113IInternal MedicineRITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes14789$0
99239Hospital discharge day management, more than 30 minutes114111$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes8280$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes1815$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 02906)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567455082View full group profile

Reviews

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Frequently asked questions

Can I verify KARL HERMAN (M.D.) with an NPI only?
You can start verification with NPI 1003253063 for KARL HERMAN (M.D.), then check state licensing separately.
Can I rely on KARL HERMAN (M.D.) being an active provider?
As of the registry snapshot, KARL HERMAN (M.D.) is marked active.
What is KARL HERMAN (M.D.)'s primary classification?
Internal Medicine Physician is the headline specialty for KARL HERMAN (M.D.) here. Clinical services aligned with this taxonomy classification.
Where is KARL HERMAN (M.D.) based?
KARL HERMAN (M.D.) is tied to Providence, Rhode Island in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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