Agustin Peralta Herber II, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837

Phone

(602) 521-5969

Fax

(602) 521-5987

NPI assigned

Mar 31, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1295430171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11369 W FOLSOM POINT DR",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856584935",
            "telephone_number": "520-870-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5969",
            "fax_number": "602-521-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBER",
        "first_name": "AGUSTIN",
        "middle_name": "PERALTA",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charley Andrew Hepfinger, PHARM.D.
• Sona Sahni Hepfinger, PHARM.D.
• Jacques P Heppell, M.D.
• Lynn C. Hepperly, LCSW
• Morgan Lee Herath, CCC-SLP
• Herbert R. Kahn, M.D., P.a.
• Lauren Bailey Herd
• Here4U Transport LLC
• Desiree Monique Heredia
• Heritage Behavioral Center, LLC

• Student in an Organized Health Care Education/Training Program in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.

Verify at the official NPI Registry.