Individual provider Active NPI

Steven Nicholas Hertz, MSOT, OTR/L

  • Occupational Therapist
  • Fargo, ND
National Provider Identifier
1043779358
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1787 Issued in ND
Practice address
4711 45TH St S Ste 103
Fargo, ND 58104-5510
Phone
(701) 222-3175
Fax
(701) 222-3186
NPI assigned
Mar 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 108122 MN
Occupational Therapist 225X00000X 1787 ND Primary

Addresses

Primary practice location

4711 45TH St S Ste 103
Fargo, ND 58104-5510

Mailing address

2625 N 19TH St
Bismarck, ND 58503-0574
Phone (701) 222-3175

Other identifiers 1

IdentifierTypeStateIssuer
1480113MedicaidND

Organizations & group practices 3

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818003982 ND Practitioner - Occupational Therapist in Private Practice 5698170330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1787NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. CurrentSince Jul 12, 2021 Accepting new patients
Red Door Pediatric Therapy, Inc Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Kaleidoscope Pediatric Therapy LLC Occupational Therapist PastSince Oct 8, 2022 Accepting new patients

Locations

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
#A
Fargo, ND 58104
Phone (701) 356-4384

NPI Registry JSON

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1043779358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 45TH ST S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045510",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "STEVEN",
        "middle_name": "NICHOLAS",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-16",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "108122",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1480113",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.