NPIMap

Individual provider Active NPI

Ethel Susan Herskovic, DO

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1104130269
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS18042 Issued in FL
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1100
Fax
(612) 294-4903
NPI assigned
Aug 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125053522 IL
Diagnostic Radiology Physician 2085R0202X OS18042 FL Primary
Diagnostic Radiology Physician 2085R0202X OS021672 PA

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130823001157 IL Practitioner - Diagnostic Radiology 1759524622 Reassigns benefits to 2 organizations
I20220119001309 FL Practitioner - Diagnostic Radiology 1759524622 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Chicago College of Osteopathy, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians
Virtual Radiologic Professionals LLCGroup PAC ID 4981608817, 392 clinicians
Atlantic Radiology Associates LLCGroup PAC ID 5799706032, 92 clinicians

Practice addresses (Care Compare)

Boca Raton, FL 33496
Phone (570) 271-6144

11650 Horizon Rd
Parkland, FL 33076-2661
Phone (336) 274-6682

3229 NW 63Rd St
Boca Raton, FL 33496-3310
Phone (952) 595-1100

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Pottstown Hospital Hospital, Pottstown, PA, CCN 390123
  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002
  • Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012
  • Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125053522ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology CurrentSince Oct 12, 2022 Accepting new patients
Warren General Hospital CurrentSince Dec 1, 2024 Accepting new patients
Atlantic Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 1, 2024 Accepting new patients
Claremont Imaging Associates, a Medical Corporation Diagnostic Radiology CurrentSince Jun 10, 2024 Accepting new patients
Warren General Hospital Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Atlantic Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 1, 2024 Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince Aug 1, 2013 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Dec 20, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Oct 12, 2022 Accepting new patients
Crawford Hospital District Current Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients

Locations

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1280620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1104130269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSKOVIC",
        "first_name": "ETHEL",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125053522",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS18042",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS021672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.