Individual provider Active NPI

Alexis Rae Hertz, DNP, APRN-CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1174396931
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0021270 Issued in OH
Practice address
7630 Southern Blvd
Youngstown, OH 44512-5633
Phone
(330) 729-8000
Fax
(330) 729-8084
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.440441 OH
Registered Nurse 163W00000X RN772525 PA
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.0021270 OH Primary

Addresses

Primary practice location

7630 Southern Blvd
Youngstown, OH 44512-5633

Mailing address

100 Debartolo PL Ste 200
Youngstown, OH 44512-6095
Phone (330) 729-8146

Other practice location 1

250 Debartolo Pl Ste 1000
Youngstown, OH 44512-6090
Phone (330) 729-8000

Other identifiers 1

IdentifierTypeStateIssuer
0126969MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604002850 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537678131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

7630 Southern Blvd
Youngstown, OH 44512-5633
Phone (330) 729-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.440441OHMDRegistered Nurse
RN772525PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2025 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

7630 Southern Blvd
Youngstown, OH 44512
Phone (330) 729-8000

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

250 Debartolo Pl
Ste 1000
Youngstown, OH 44512
Phone (330) 314-9100

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1174396931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DEBARTOLO PL STE 200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126095",
            "telephone_number": "330-729-8146",
            "fax_number": "330-965-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 SOUTHERN BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125633",
            "telephone_number": "330-729-8000",
            "fax_number": "330-729-8084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Debartolo Pl Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445126090",
            "country_code": "US",
            "telephone_number": "330-729-8000",
            "fax_number": "330-729-8084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "ALEXIS",
        "middle_name": "RAE",
        "credential": "DNP, APRN-CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.440441",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN772525",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0021270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126969",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.