Individual provider Active NPI

Ian C. Herskowitz, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Augusta, GA
National Provider Identifier
1295880680
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
34157 Issued in GA
Practice address
820 Saint Sebastian Way Ste 4a
Augusta, GA 30901
Phone
(706) 774-5995
Fax
(706) 774-5996
NPI assigned
Jan 24, 2007
Last updated
Oct 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 34157 GA Primary

Addresses

Primary practice location

820 Saint Sebastian Way Ste 4a
Augusta, GA 30901

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7760

Other practice location 1

1303 Dantignac St
Suite 1200
Augusta, GA 30901-2775
Phone (706) 774-7760

Other practice location 2

4321 University Pkwy Ste 101
Evans, GA 30809-3093
Phone (706) 774-5995

Other identifiers 4

IdentifierTypeStateIssuer
G34157MedicaidSC
00713292AMedicaidGA
110051869OtherRAILROAD MEDICARE
11D0687551OtherCLIA NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090709000373 GA Practitioner - Internal MedicinePractitioner - Endocrinology 1153473921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

51 Hospital Rd
Newnan, GA 30263-1209
Phone (770) 251-5540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34157GAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

4321 University Pkwy
Ste 101
Evans, GA 30809
Phone (706) 774-7400

51 Hospital Rd
Newnan, GA 30263
Phone (770) 251-5540

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1295880680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7760",
            "fax_number": "706-774-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SAINT SEBASTIAN WAY STE 4A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "706-774-5995",
            "fax_number": "706-774-5996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 Dantignac St",
            "address_2": "Suite 1200",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012775",
            "country_code": "US",
            "telephone_number": "706-774-7760",
            "fax_number": "706-774-7766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4321 University Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093093",
            "country_code": "US",
            "telephone_number": "706-774-5995",
            "fax_number": "706-774-5996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERSKOWITZ",
        "first_name": "IAN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "34157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G34157",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00713292A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110051869",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "11D0687551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.