Scott Michael Herman, PA-C , MHP
Individual provider Active NPI Surgical Physician Assistant · Boston, MD
NPI 1497919211 · NPPES record last updated Jul 10, 2008
Key facts
- NPI
- 1497919211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 111 (MA)
- Practice address
- 330 Brookline Ave
Beth Israel Deconess Med Ctr
Boston, MD 02215-2215 - Phone
- (617) 632-8069
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080908000451 | MA | Practitioner - Physician Assistant | 6002982535 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111 | MA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current |
Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current |
Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients |
Locations
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
Interoperability endpoints
- sherman253829@direct.bilh.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 111 | MA | Yes |
Addresses
Primary practice location
330 Brookline Ave
Beth Israel Deconess Med Ctr
Boston, MD 02215-2215
Mailing address
330 Brookline Ave
Beth Israel Deconess Med Ctr
Boston, MA 02215-2215
Phone (617) 632-8069
Other providers in Boston, MD
All providers in Boston, MD · Surgical Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.