2026 NPPES data Ophthalmology Physician NPI 1053454009 M.D.
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James Heroman, M.D.

Ophthalmology Physician in Charlotte, North Carolina. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 22,090 in Ophthalmology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.

Federal data, no proprietary rating. We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
210
Medicare Part D claims · 69 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
50%
generic claims · 50% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · Exceptional
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

James Heroman, M.D. reported a CMS MIPS final score of 100/100 - above the 83.1 national average - and filed 210 Medicare Part D claims in 2023.

100/100
MIPS score · +17 vs avg
210
Part D claims, 2023
50%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.

James Heroman, M.D.'s MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure

100 Top 7% higher than 93% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90+: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where James Heroman, M.D. sits

This provider among ophthalmology physician peers

Across the 9,866 ophthalmology physician providers who report both Medicare Part D prescribing and a MIPS quality score, James Heroman, M.D. writes more Part D claims than 11% of them and scores higher on MIPS quality than 85% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Part D claim volume vs MIPS quality, by specialty percentile

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.148.372.496.6Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 65Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 80James Heroman, M.D.-Part D claim volume, percentile in specialty: 11 · MIPS quality, percentile: 85
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one ophthalmology physician peer from a representative sample of 60; the gold marker is James Heroman, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

James Heroman, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about James Heroman, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 02/15/2007

NPI 1053454009

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

210 85% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

100/100 16.9 pts vs avg

Exceptional band

vs 83.1 national avg

Specialty distribution in North Carolina

How Ophthalmology Physician compares to other specialties among North Carolina providers

North Carolina providers
Clinical Social Worker - 7.1%Clinical Social Worker7.1%Behavior Technician - 6.4%Behavior Technician6.4%Pharmacist - 5%Pharmacist5%Student in an Organized Health Care Education/Training Program - 4.5%Student in an Organized Health Care Education/Training Program4.5%Physical Therapist - 4.3%Physical Therapist4.3%Physician Assistant - 4.2%Physician Assistant4.2%Ophthalmology Physician - 0.3%Ophthalmology Physician0.3%
Largest specialties in North Carolina (% of in-state providers)

Medicare quality performance, MIPS

James Heroman, M.D.'s 2023 MIPS final score plotted against the Ophthalmology Physician national average

High performer (top quartile)
MIPS Final Score
100/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) - 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Ophthalmology Physician) - 100/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

James Heroman, M.D. appears in the CMS NPPES registry as a Ophthalmology Physician provider holding M.D. credentials at 497 N WENDOVER RD, Charlotte, NC, 28211, with a listed phone of (704) 376-5424. NPI 1053454009 was issued on 02/15/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Heroman most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 210 prescription claims written by this provider, covering 69 Medicare beneficiaries and totaling roughly $17K in drug spend, split 50% brand-name and 50% generic by claim count. These figures capture only Medicare Part D, commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 100/100 for the 2023 performance year (Quality 100), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

497 N WENDOVER RD
Charlotte, NC 28211

Provider Details

NPI 1053454009
Specialty Ophthalmology Physician
Credentials M.D.
Gender Male
NPI Issued 02/15/2007

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

100
Final Score
Avg: 83.1
100
Quality

Reporting: Individual

Brand vs generic prescribing mix · Brand-heavy

James Heroman, M.D. - brand share 50.0%
Ophthalmology Physician average

50% brand-name claims vs 50% generic, on 210 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

210
Total Claims
$17K
Total Drug Cost
69
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
303
Total Day Supply
7,697
Brand vs Generic
50% brand / 50% generic
Brand Drug Cost
$12K
Generic Drug Cost
$5K

Patient Demographics

Average Patient Age
77.5 years
Avg HCC Risk Score
1.28
Gender Split
59% female / 41% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What James Heroman, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Prednisolone Acetate
51
Latanoprost
32
Ketorolac Tromethamine
25
Dorzolamide Hcl
19

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Ophthalmology Physician Overview

How James Heroman, M.D. fits within the Ophthalmology Physician landscape nationally.

22,090
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider

James Heroman, M.D.'s 210 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as Heroman.

Compare Ophthalmology Physician nationally: see state-by-state distribution →

Before you book an appointment

Use this federal record as your verification checklist, not as a recommendation.

  • Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
  • Check the active license and any disciplinary history with the North Carolina medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Ophthalmology Physician peer on Medicare volume and prescribing patterns. Compare providers

Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.

Frequently Asked Questions

What is James Heroman, M.D.'s specialty?
James Heroman, M.D. specializes in Ophthalmology Physician and practices in Charlotte, North Carolina. Credentials: M.D..
How much does James Heroman, M.D. prescribe under Medicare Part D?
In 2023, James Heroman, M.D. wrote 210 Medicare Part D claims totaling $17K in drug costs for 69 beneficiaries.
What is James Heroman, M.D.'s Medicare quality score?
James Heroman, M.D. has a CMS MIPS Final Score of 100/100 (Quality: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is James Heroman, M.D. located?
James Heroman, M.D. is located at 497 N WENDOVER RD, Charlotte, NC, 28211. Phone: (704) 376-5424.
What is James Heroman, M.D.'s NPI number?
James Heroman, M.D.'s National Provider Identifier (NPI) is 1053454009, issued on 02/15/2007.
Does James Heroman, M.D. prescribe more brand-name or generic drugs?
James Heroman, M.D.'s prescribing is 50% brand-name and 50% generic drugs by claim count, with $12K in brand drug costs.
How many Ophthalmology Physician providers are there in the US?
There are 22,090 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does James Heroman, M.D. prescribe most often?
Based on 2023 Medicare Part D data, James Heroman, M.D.'s most frequently prescribed drugs include Prednisolone Acetate, Latanoprost, Ketorolac Tromethamine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Heroman, M.D. accept Medicare?
James Heroman, M.D. appears in CMS Medicare data with 210 Part D claims and 69 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Heroman, M.D.'s credentials?
James Heroman, M.D.'s NPI is 1053454009 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology

Compiled from official public sources by the PlainDoctor editorial team.