Thomas James Heriza, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

12436 Issued in MT

Practice address

1871 S 22ND Ave Ste 3
Bozeman, MT 59718-7054

Phone

(406) 585-3584

Fax

(406) 534-0411

NPI assigned

Dec 13, 2006

Last updated

Apr 4, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 13, 2017 through Sep 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Susanna Turner Aprn PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bozeman, MT
  • NPI 1437665650
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1083775035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 S. 22ND AVE STE 3",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187054",
            "telephone_number": "406-585-3584",
            "fax_number": "406-534-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 S 22ND AVE STE 3",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187054",
            "telephone_number": "406-585-3584",
            "fax_number": "406-534-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERIZA",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "12436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150582",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amelia Elizabeth Hennessy
• Julie S Henningsen, PA-C
• Blair Hensen, LCPC
• Jack Hensold, MD
• Katherine I Herczeg, APRN
• Andrew Herman, M.D.
• Julia Heron Braccini, LCPC
• Michael Herring, MD
• Gabrielle Herron-Tammetta, PCLC
• Lindsay E. Herron, LAC

• Psychiatry Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Psychiatry Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.