Stacey A Hertz, PAAA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2690 Issued in GA

Practice address

1365 Clifton Rd NE
Atlanta, GA 30322-1013

Phone

(404) 778-4852

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stacey Anne Forest Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Emory University School of Medicine, 1995

Medicare assignment

May accept Medicare assignment

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

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.

• Mak Anesthesia Holdings LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1912452939
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment NPD
• Piedmont Anesthesia LLC

  • Anesthesiology Physician
  • Stockbridge, GA
  • NPI 1700474244
  Medicare reassignment NPD
• The Emory Clinic Pediatric Providers

  • Pediatric Surgery Physician
  • Decatur, GA
  • NPI 1720285653
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1376578229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE BLDG 2ND",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082247",
            "telephone_number": "404-686-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "002690",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "2690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10000327A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "FOREST",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bruce Warren Hershatter, M.D.
• Mary Sims Hershey
• Tonya Hershman, PHARMD
• Abdihakim Hassan Hersi, RPH
• Craig William Hertz, DO
• Barbara L Herwaldt, MD, MPH
• Suleiman Farag Herwis, MD
• Joseph R Herzberger, PA
• Kathleen Lynn Herzer, LMSW
• David Warren Herzig, MD

• Anesthesiology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.