Individual provider Active NPI

David A Herzog, MD

  • Internal Medicine Physician
  • Rye, NY
National Provider Identifier
1093788374
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151221 Issued in NY
Practice address
1 Theall Rd
Rye, NY 10580-1404
Phone
(914) 848-8700
Fax
(914) 682-6403
NPI assigned
Feb 8, 2006
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151221 NY Primary

Addresses

Primary practice location

1 Theall Rd
Rye, NY 10580-1404

Mailing address

210 Westchester Ave
The Westchester Medical Group
White Plains, NY 10604
Phone (914) 682-6538

Other identifiers 1

IdentifierTypeStateIssuer
01194325MedicaidNY

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
I20060828000413 NY Practitioner - Internal Medicine 2163475773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

1 Theall Rd
Rye, NY 10580-1404
Phone (914) 848-8888

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

3030 Westchester Ave
Purchase, NY 10577-2574
Phone (914) 831-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151221NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Docs Physicians Affiliated With Bimc Internal Medicine Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: davidherzog@hiemail.healtheconnections.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1093788374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "address_2": "THE WESTCHESTER MEDICAL GROUP",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10604",
            "telephone_number": "914-682-6538",
            "fax_number": "914-682-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 THEALL RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105801404",
            "telephone_number": "914-848-8700",
            "fax_number": "914-682-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "151221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01194325",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rye, NY

Sources for this page

Verify at the official NPI Registry.