Active NPI
Roxanne E Hertzog, M.D.
- Anesthesiology Physician
- Everett, WA
National Provider Identifier
1073503181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD00032736
- Practice address
- 1100 Pacific Ave
Suite 100
Everett, WA 98201-4261 - Phone
- (206) 244-1212
- Fax
- (206) 244-1223
- NPI assigned
- Oct 28, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD00032736 | WA | Primary |
Addresses
Primary practice location
1100 Pacific Ave
Suite 100
Everett, WA 98201-4261
Mailing address
PO Box 5908
Bellevue, WA 98006-0408
Phone (206) 244-1212
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8938073 | Other | WA | CRIME VICTIMS PROGRAM |
| 4682HE | Other | WA | REGENCE BLUE SHIELD |
| 0184996 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| 8017535 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00032736 | WA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen Markowitz | Anesthesiology | 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.
-
- Anesthesiology Physician
- Seattle, WA
- NPI 1801966288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1073503181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5908",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980060408",
"telephone_number": "206-244-1212",
"fax_number": "206-244-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 PACIFIC AVE",
"address_2": "SUITE 100",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014261",
"telephone_number": "206-244-1212",
"fax_number": "206-244-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERTZOG",
"first_name": "ROXANNE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-28",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD00032736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS PROGRAM",
"identifier": "8938073",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "4682HE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "0184996",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8017535",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.