Individual provider Active NPI

Mary Catherine Hertl, MD

  • Plastic Surgery Physician
  • Beverly, MA
National Provider Identifier
1386611630
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
212487 Issued in MA
Practice address
900 Cummings Ctr
Ste 216T
Beverly, MA 01915-6225
Phone
(978) 969-2081
Fax
(978) 969-2084
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 212487 MA Primary

Addresses

Primary practice location

900 Cummings Ctr
Ste 216T
Beverly, MA 01915-6225

Mailing address

5 Essex Green Dr
Ste 36
Peabody, MA 01960-2921
Phone (978) 969-2081

Other identifiers 3

IdentifierTypeStateIssuer
0183466MedicaidMA
212487OtherMATUFTS HEALTH PLAN
J25485OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386611630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ESSEX GREEN DR",
            "address_2": "STE 36",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602921",
            "telephone_number": "978-969-2081",
            "fax_number": "978-969-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR",
            "address_2": "STE 216T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156225",
            "telephone_number": "978-969-2081",
            "fax_number": "978-969-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTL",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "212487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0183466",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "212487",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J25485",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.