Active NPI
John Peter Herzog, D.O.
- Orthopaedic Surgery Physician
- Falmouth, ME
National Provider Identifier
1265642425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1107
- Practice address
- 98 Clearwater Dr
Suite 4
Falmouth, ME 04105-1398 - Phone
- (207) 781-9077
- Fax
- (207) 347-8285
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 1107 | ME | Primary |
Addresses
Primary practice location
98 Clearwater Dr
Suite 4
Falmouth, ME 04105-1398
Mailing address
98 Clearwater Dr
Suite 4
Falmouth, ME 04105-1398
Phone (207) 781-9077
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1107 | ME | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Flint Sports Medicine Center | Orthopaedic Surgery | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Grand Blanc, MI
- NPI 1760701106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1265642425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 CLEARWATER DR",
"address_2": "SUITE 4",
"city": "FALMOUTH",
"state": "ME",
"postal_code": "041051398",
"telephone_number": "207-781-9077",
"fax_number": "207-347-8285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 CLEARWATER DR",
"address_2": "SUITE 4",
"city": "FALMOUTH",
"state": "ME",
"postal_code": "041051398",
"telephone_number": "207-781-9077",
"fax_number": "207-347-8285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZOG",
"first_name": "JOHN",
"middle_name": "PETER",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "ME",
"license": "1107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falmouth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.