Individual provider Active NPI

Kurt Thomas Herman, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Walpole, MA
National Provider Identifier
1093913048
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN1855567 Issued in MA
Practice address
841 Maint St
Walpole, MA 02081
Phone
(508) 660-2900
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4370 SC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN1855567 MA Primary

Addresses

Primary practice location

841 Maint St
Walpole, MA 02081

Mailing address

841 Maint St
Walpole, MA 02081
Phone (508) 660-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110912000115 MA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 2961673561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Univ of Pennsylvania School of Dental Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

841 Main St
Walpole, MA 02081-2997
Phone (508) 660-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4370SCMDOral and Maxillofacial Surgery (Dentist)

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1093913048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MAINT ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "02081",
            "telephone_number": "508-660-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MAINT ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "02081",
            "telephone_number": "508-660-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "KURT",
        "middle_name": "THOMAS",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "4370",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1855567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.