Individual provider Active NPI

Joseph R Herzberger, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1205877438
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004347 Issued in GA
Practice address
1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone
(404) 851-8000
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004347 GA
Physician Assistant 363A00000X 004347 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Mailing address

PO Box 2968
Kennesaw, GA 30156-9117
Phone (770) 779-0015

Other identifiers 5

IdentifierTypeStateIssuer
740575585BMedicaidGA
740575585MedicaidGA
740575585CMedicaidGA
10044975OtherGAAMERIGROUP
333514OtherGAWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920001088 GA Practitioner - Physician Assistant 1850369687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004347GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Woundcare MD LLC PastSince Oct 1, 2024 Accepting new patients

Organizations & group practices 3

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1205877438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301569117",
            "telephone_number": "770-779-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERGER",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004347",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740575585B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740575585",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740575585C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10044975",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "333514",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.