Individual provider Active NPI

Edward Richard Herman, MD

  • Psychiatry Physician
  • Orangeburg, NY
National Provider Identifier
1053386904
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
156650-1 Issued in NY
Practice address
140 Old Orangeburg Rd
Orangeburg, NY 10962-1157
Phone
(845) 680-8308
Fax
(845) 680-5580
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 156650-1 NY Primary

Addresses

Primary practice location

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157

Mailing address

34 Carriage CT
Scarsdale, NY 10583-6620
Phone (845) 680-8308

Other identifiers 1

IdentifierTypeStateIssuer
00958296MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180201001917 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 6406883131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156650-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Office of Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1053386904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CARRIAGE CT",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105836620",
            "telephone_number": "845-680-8308",
            "fax_number": "845-680-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-680-8308",
            "fax_number": "845-680-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "EDWARD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "156650-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00958296",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, NY

Sources for this page

Verify at the official NPI Registry.