Individual provider Active NPI

Kenneth L. Herman, DO

  • Emergency Medicine Physician
  • Passaic, NJ
National Provider Identifier
1356382550
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MB50008 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 365-5110
Fax
(973) 470-5944
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MB50008 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Other identifiers 1

IdentifierTypeStateIssuer
0647900MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180316000556 NY Practitioner - Emergency Medicine 5698676310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

179 N Broad St
Norwich, NY 13815-1019
Phone (607) 337-4111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
86.36
Promoting interoperability
99
Improvement activities
40
Cost
79.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB50008NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Mar 11, 2018 Accepting new patients
United Medical Associates, P.C. CurrentSince Mar 11, 2018 Accepting new patients
Chenango Memorial Hospital Inc Current Accepting new patients
Chenango Memorial Hospital, Inc. Emergency Medicine CurrentSince Feb 20, 2018 Accepting new patients
Chenango Memorial Hospital Inc Emergency Medicine CurrentSince Feb 20, 2018 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine Past Accepting new patients

Locations

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

179 N Broad St
Norwich, NY 13815
Phone (607) 337-4111

2 Titus Pl
Walton, NY 13856
Phone (607) 865-2197

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1356382550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-5110",
            "fax_number": "973-470-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "KENNETH",
        "middle_name": "L.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MB50008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0647900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.