Individual provider Active NPI

John C Hergert, CRNA

  • Certified Registered Nurse Anesthetist
  • Rutland, VT
National Provider Identifier
1053548727
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101-0054298 Issued in VT
Practice address
160 Allen Street
Rutland, VT 05701
Phone
(802) 747-1700
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 101-0054298 VT Primary

Addresses

Primary practice location

160 Allen Street
Rutland, VT 05701

Mailing address

1613 Harrison Pkwy
Suite 200 Mailstop SH-9a
Sunrise, FL 33323-2896
Phone (954) 838-2371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150825005551 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193861813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agcny Physicians PLLCGroup PAC ID 4284804345, 36 clinicians
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

4309 Medical Ctr Dr
Fayetteville, NY 13066-6638
Phone (315) 329-7300

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 498-6200

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
101-0054298VTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Agcny Physicians PLLC CurrentSince Jan 25, 2016 Accepting new patients
Chag Anesthesia PC CurrentSince Jul 13, 2015 Accepting new patients

Locations

4939 Brittonfield Pkwy
East Syracuse, NY 13057
Phone (315) 463-1600

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

4302 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 423-9722

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

4900 Broad Rd
Bldg S
Syracuse, NY 13215
Phone (315) 299-5313

4900 Broad Rd
Ste 2D
Syracuse, NY 13215
Phone (315) 255-0606

195 Intrepid Ln
Syracuse, NY 13205
Phone (315) 469-6789

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1053548727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "address_2": "SUITE 200 MAILSTOP SH-9A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLEN STREET",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "05701",
            "telephone_number": "802-747-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERGERT",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VT",
            "license": "101-0054298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.