Individual provider Active NPI

Mark Herrera, D.C.

  • Chiropractor
  • Victorville, CA
National Provider Identifier
1497575831
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC37084 Issued in CA
Practice address
17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone
(760) 245-8182
Fax
(760) 245-2123
NPI assigned
Oct 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC37084 CA Primary

Addresses

Primary practice location

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395

Mailing address

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-8182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250304000931 CA Practitioner - Chiropractic 9032630389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HD Physical Medicine a Professional Medical CorporationGroup PAC ID 3678974243, 10 clinicians

Practice addresses (Care Compare)

17330 Bear Valley Rd
Suite 105
Victorville, CA 92395-7741
Phone (760) 245-5182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC37084CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
HD Physical Medicine, a Professional Medical Corporation Chiropractor CurrentSince Feb 21, 2025 Accepting new patients

Locations

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-5182

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1497575831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MARK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC37084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.