Active NPI
Steven Nicholas Hertz, MSOT, OTR/L
- Occupational Therapist
- Fargo, ND
National Provider Identifier
1043779358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1787
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1480113 | Medicaid | ND |
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.
-
- Speech-Language Pathologist
- Bismarck, ND
- NPI 1639257033
ND, Occupational Therapist
-
- Early Intervention Provider Agency
- Fargo, ND
- NPI 1104426352
-
- Occupational Therapist
- Boise, ID
- NPI 1154693364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1787 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Partners, Inc. | Current | Accepting new patients | |
| Red Door Pediatric Therapy, Inc | Occupational Therapist | Current | Accepting new patients |
| Kaleidoscope Pediatric Therapy LLC | Occupational Therapist | Past | 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.