Lara Kristine Herzog, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

038070 Issued in NY

Practice address

48 Douglas LN
East Aurora, NY 14052-2124

Phone

(716) 714-9860

Fax

(716) 714-9864

NPI assigned

Nov 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lara Kristine Spiegel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ans Optometry, PLLC

  • Medical Specialty Clinic/Center
  • East Aurora, NY
  • NPI 1780452730
  NPD
• Texas Luna Care Physical Therapy LLC

  • Physical Therapist
  • Southlake, TX
  • NPI 1790309656
  NPD
• MSK Group PC

  • Orthopaedic Surgery Physician
  • Southaven, MS
  • NPI 1912303447

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1326445867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 8000",
            "address_2": "DEPT 314",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "716-213-0772",
            "fax_number": "716-324-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 DOUGLAS LN",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522124",
            "telephone_number": "716-714-9860",
            "fax_number": "716-714-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "LARA",
        "middle_name": "KRISTINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10948",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7537",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05899665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "SPIEGEL",
            "middle_name": "KRISTINE",
            "credential": "PT DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen M Hayes, PNP
• Healing Waters of Wny LLC
• Kimberly Heeb, WHNP/CNM
• Samantha Heinaman, LMT
• Karen Margaret Herdzik, PH.D.
• Jeanne E. Hill, AU.D.
• Hannah Howard
• Melinda Hulme, M.A. CCC-SLP
• Teresa Ann Huston, LPN
• Thomas Joseph Insinna, DC

• Physical Therapist in East Aurora, NY
• Providers in East Aurora, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.