Active NPI
Herbert Hermele, MD
- Orthopaedic Surgery Physician
- Fairfield, CT
National Provider Identifier
1194833921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 017779
- Practice address
- 305 Black Rock Tpke
Orthopaedic Specialty Group
Fairfield, CT 06825-5508 - Phone
- (203) 337-2600
- Fax
- (203) 337-2666
- NPI assigned
- Aug 29, 2006
- Last updated
- Mar 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 017779 | CT | Primary |
Addresses
Primary practice location
305 Black Rock Tpke
Orthopaedic Specialty Group
Fairfield, CT 06825-5508
Mailing address
305 Black Rock Tpke
Orthopaedic Specialty Group
Fairfield, CT 06825-5508
Phone (203) 337-2600
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZS305 | Other | CT | OXFORD HEALTH PLANS |
| TIN | Other | POMCO | |
| TIN | Other | ORTHONET | |
| 010017779CT01 | Other | CT | ANTHEM BC/BS |
| TIN | Other | NORTHEAST HEALTH DI RECT | |
| 000503 | Other | CT | HEALTH NET |
| TIN | Other | UNITED HEALTHCARE | |
| TIN | Other | GREAT WEST | |
| TIN | Other | CORVEL | |
| 0085203 | Other | CT | AETNA |
| TIN | Other | NATIONAL PROVIDER NETWORK | |
| 001177799 | Medicaid | CT | |
| TIN | Other | NECHA HMC /PPO | |
| TIN | Other | FIRST HEALTH / CCN | |
| 517779 | Other | CT | CONNECTICARE |
| TIN | Other | CIGNA | |
| TIN | Other | PIONEER | |
| 299241 (2) (3) | Other | CT | EMPIRE BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017779 | CT | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1194833921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 BLACK ROCK TPKE",
"address_2": "ORTHOPAEDIC SPECIALTY GROUP",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068255508",
"telephone_number": "203-337-2600",
"fax_number": "203-337-2666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 BLACK ROCK TPKE",
"address_2": "ORTHOPAEDIC SPECIALTY GROUP",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068255508",
"telephone_number": "203-337-2600",
"fax_number": "203-337-2666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMELE",
"first_name": "HERBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CT",
"license": "017779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "ZS305",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "POMCO",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORTHONET",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "010017779CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHEAST HEALTH DI RECT",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "000503",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0085203",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER NETWORK",
"identifier": "TIN",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001177799",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NECHA HMC /PPO",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH / CCN",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "517779",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIONEER",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "299241 (2) (3)",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.