Brandon Hertzog

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

81784 Issued in TX

Practice address

7011 Declan Vly
San Antonio, TX 78242-1020

Phone

(210) 526-1887

NPI assigned

Apr 17, 2017

Last updated

Aug 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• Direct secure messaging: brandonhertzog@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  NPD

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1073047080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 DECLAN VLY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782421020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 DECLAN VLY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782421020",
            "telephone_number": "210-526-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZOG",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "81784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Strickler Herron
• Bridget Herschap, M.D.
• Diem CHI Herscovici, O.D.
• Daren Harold Hersh, M.D.
• Lisa Jones Hersom, RN
• Michael Anthony Herzik, M.D.
• Herzog San Antonio PC (Floss)
• Cameron Herzog
• Hesed Counseling PC
• Edsel Lumbis Hesita, M.D.

• Mental Health Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.