Individual provider Active NPI

Bradley Charles Herzberg, FNP

  • Family Nurse Practitioner
  • Flint, MI
National Provider Identifier
1457064669
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704286267 Issued in MI
Practice address
4800 S Saginaw St
Flint, MI 48507-2677
Phone
(810) 275-9333
NPI assigned
Jan 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704286267 MI Primary

Addresses

Primary practice location

4800 S Saginaw St
Flint, MI 48507-2677

Mailing address

2101 E Court St
Flint, MI 48503-6416
Phone (989) 395-4475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110001295 MI Practitioner - Nurse Practitioner 9335519263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

4800 S Saginaw St
Flint, MI 48507-2677

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141
  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197
  • Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264
  • Hurley Medical Center Hospital, Flint, MI, CCN 230132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah MD PC CurrentSince Jan 1, 2023 Accepting new patients
Jawad a Shah, MD PC CurrentSince Jan 1, 2023 Accepting new patients

Locations

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

Interoperability endpoints

  • Direct secure messaging: bherzberg1132063@direct.hfhs.org

Organizations & group practices 2

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 4

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": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1457064669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E COURT ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485036416",
            "telephone_number": "989-395-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072677",
            "telephone_number": "810-275-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG",
        "first_name": "BRADLEY",
        "middle_name": "CHARLES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704286267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.