James Mark Hertzog, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2584 Issued in AR

Practice address

1004 S Pine St Ste F
Cabot, AR 72023-3864

Phone

(501) 941-2222

Fax

(501) 941-2577

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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.

• Hertzog Family Eye Care PA

  • Optometrist
  • Cabot, AR
  • NPI 1801029574

  AR, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Flippin-Westfall Eyecare Center PC

  • Optometrist
  • Searcy, AR
  • NPI 1922060755
  NPD (past)
• Jacksonville Vision Development Center PA

  • Optometrist
  • Jacksonville, AR
  • NPI 1336782846
  NPD (past)

Specialty

Optometry

Education

Southern College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hertzog Family Eye Care PA 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2013.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1124052188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S PINE ST STE F",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233864",
            "telephone_number": "501-941-2222",
            "fax_number": "501-941-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S PINE ST STE F",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233864",
            "telephone_number": "501-941-2222",
            "fax_number": "501-941-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZOG",
        "first_name": "JAMES",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "499837373",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167794722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "49983",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC REGION C",
            "identifier": "0215420001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINKPPO",
            "identifier": "882128",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00450889",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Kay Hendrix, LMSW
• Katherine Henkel, LMSW
• Leonda Hensley, LCSW
• Michelle Ann Herriott, RRT
• Hertzog Family Eye Care PA
• Devyn Hicks, PHARMD
• Laura Hicks
• Bailey Higgins
• E'Nyliah M Higgins
• Patrice D Higgins, MHPP

• All providers in Cabot, AR
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.