Individual provider Active NPI

Richard Avery Herman Jr., MD

  • Student in an Organized Health Care Education/Training Program
  • Pittsburgh, PA
National Provider Identifier
1033558978
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9104 Babcock Blvd
5TH Floor
Pittsburgh, PA 15237
Phone
(706) 721-0211
NPI assigned
Jun 24, 2013
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Orthopaedic Surgery Physician 207X00000X 006165 GA

Addresses

Primary practice location

9104 Babcock Blvd
5TH Floor
Pittsburgh, PA 15237

Mailing address

3600 Forbes Suite 140
Plaza Level Suite 140
Pittsburgh, PA 15213
Phone (706) 721-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906000330 GA Practitioner - Orthopedic Surgery 8527200617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrollton Orthopaedic Clinic PCGroup PAC ID 7810989183, 31 clinicians

Practice addresses (Care Compare)

150 Clinic Ave
Carrollton, GA 30117-4498
Phone (770) 834-0873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
006165GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Orthopaedic Clinic PC Orthopaedic Surgery CurrentSince Sep 1, 2019 Accepting new patients
West Ga. Nurse Anesthesia, LLC PastSince Sep 1, 2019 Accepting new patients

Locations

204 Allen Memorial Dr
Ste 102
Bremen, GA 30110
Phone (727) 755-0679

150 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Ste 101
Carrollton, GA 30117
Phone (770) 834-0873

705 Dallas Hwy
Ste 301
Villa Rica, GA 30180
Phone (770) 456-0211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1033558978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES SUITE 140",
            "address_2": "PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "706-721-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 BABCOCK BLVD",
            "address_2": "5TH FLOOR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15237",
            "telephone_number": "706-721-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "RICHARD",
        "middle_name": "AVERY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "006165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.