Individual provider Active NPI

Kara Hertzfeld, MD

  • Radiation Oncology Physician
  • Maumee, OH
National Provider Identifier
1174742472
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
35095467 Issued in OH
Practice address
5805 Monclova Rd
Maumee, OH 43537-1839
Phone
(419) 824-1952
Fax
(419) 824-0344
NPI assigned
Apr 25, 2007
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4301097412 MI
Radiation Oncology Physician 2085R0001X 35095467 OH Primary

Addresses

Primary practice location

5805 Monclova Rd
Maumee, OH 43537-1839

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (567) 585-1992

Other identifiers 4

IdentifierTypeStateIssuer
1174742472OtherMIMI MEDICAID-OH LOCATIONS
P00900979OtherOHRR MEDICARE
1174742472MedicaidMI
3085889MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khertzfeld14148@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101025000118 OH Practitioner - Radiation Oncology 5698968592 Reassigns benefits to 2 organizations
I20101120000091 MI Practitioner - Radiation Oncology 5698968592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Cincinnati College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

718 N Macomb St
Monroe, MI 48162-7815
Phone (419) 240-8835

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35095467OHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Sep 1, 2018 Accepting new patients
Promedica Central Physicians CurrentSince Sep 1, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

777 Kimole Ln
Adrian, MI 49221
Phone (517) 263-3393

777 Kimole Ln
Ste 130
Adrian, MI 49221
Phone (517) 265-0292

800 Stewart Rd
Ste A
Monroe, MI 48162
Phone (734) 240-1800

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

5805 Monclova Rd
Maumee, OH 43537
Phone (419) 824-1952

1620 Brigham Dr
Ste 110
Perrysburg, OH 43551
Phone (419) 891-5600

5300 Harroun Rd
Ste 10
Sylvania, OH 43560
Phone (419) 824-1952

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

1 Seagate
Ste 800
Toledo, OH 43604

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

1091 Pray Blvd
Waterville, OH 43566
Phone (419) 785-3282

Organizations & group practices 4

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 4

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1174742472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "567-585-1992",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371839",
            "telephone_number": "419-824-1952",
            "fax_number": "419-824-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZFELD",
        "first_name": "KARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301097412",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35095467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICAID-OH LOCATIONS",
            "identifier": "1174742472",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00900979",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174742472",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3085889",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khertzfeld14148@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 Maumee, OH

Sources for this page

Verify at the official NPI Registry.