Individual provider Active NPI

Milton Boyd Herndon, DO PA

  • Facial Plastic Surgery Physician
  • Port Neches, TX
National Provider Identifier
1235154758
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
G9118 Issued in TX
Practice address
886 Sierra Dr
Port Neches, TX 77651-5607
Phone
(406) 729-6401
Fax
(409) 729-6015
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X G9118 TX Primary
Allergy & Immunology Physician 207K00000X G9118 TX

Addresses

Primary practice location

886 Sierra Dr
Port Neches, TX 77651-5607

Mailing address

886 Sierra Dr
Port Neches, TX 77651-5607
Phone (406) 729-6401

Other identifiers 2

IdentifierTypeStateIssuer
168285801MedicaidTX
120264005MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040615000141 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive SurgeryPractitioner - Allergy/Immunology 8820072234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Plastic and Reconstructive Surgery
Education
West Virginia School of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

886 Sierra Dr
Port Neches, TX 77651-5607
Phone (409) 729-6401

Hospital & facility affiliations

  • The Medical Center of Southeast Texas Hospital, Port Arthur, TX, CCN 450518
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
G9118TXMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Boyd Herndon, D.O., P.a. Allergy & Immunology CurrentSince Sep 1, 1985 Accepting new patients

Locations

886 Sierra Dr
Port Neches, TX 77651
Phone (406) 729-6401

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1235154758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "406-729-6401",
            "fax_number": "409-729-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "406-729-6401",
            "fax_number": "409-729-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "MILTON",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "DO PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "G9118",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "G9118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168285801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120264005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Neches, TX

Sources for this page

Verify at the official NPI Registry.