Individual provider Active NPI

Jonathan D Herschman, M.D.

  • Urology Physician
  • Adrian, MI
National Provider Identifier
1154353076
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301075936 Issued in MI
Practice address
777 Kimole LN Ste 260
Adrian, MI 49221-1400
Phone
(517) 265-4770
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301075936 MI Primary

Addresses

Primary practice location

777 Kimole LN Ste 260
Adrian, MI 49221-1400

Mailing address

1 Seagate # 800
Toledo, OH 43604-1558

Other practice location 1

5333 McAuley Dr
Ste 6110
Ypsilanti, MI 48197-1014
Phone (734) 434-1000

Other identifiers 1

IdentifierTypeStateIssuer
104276189MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jherschman25191@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110321000642 MI Practitioner - Urology 7113100686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central Corporation of MichiganGroup PAC ID 7012902265, 112 clinicians

Practice addresses (Care Compare)

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

5640 N Adrian Hwy
Adrian, MI 49221-8318
Phone (419) 291-4491

777 Kimole LN
Adrian, MI 49221-1400

Hospital & facility affiliations

  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Corporation of Michigan CurrentSince Feb 1, 2018 Accepting new patients
Iha Health Service Corporation CurrentSince May 30, 2013 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Urology CurrentSince May 30, 2013 Accepting new patients
Michigan Multispecialty Physicians, P.C. Urology Past Accepting new patients

Locations

777 Kimole Ln
Ste 230
Adrian, MI 49221
Phone (517) 263-5655

777 Kimole Ln
Ste 260
Adrian, MI 49221
Phone (419) 479-2650

16507 Southfield Rd
Allen Park, MI 48101
Phone (313) 389-0648

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

420 W Russell St
Ste 203
Saline, MI 48176
Phone (734) 429-1234

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

5333 McAuley Dr
Rm 6110
Ypsilanti, MI 48197
Phone (734) 434-1000

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: jherschman25191@direct.promedica.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1154353076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE # 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 KIMOLE LN STE 260",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211400",
            "telephone_number": "517-265-4770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5333 McAuley Dr",
            "address_2": "Ste 6110",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971014",
            "country_code": "US",
            "telephone_number": "734-434-1000",
            "fax_number": "734-434-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERSCHMAN",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301075936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104276189",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jherschman25191@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.