Individual provider Active NPI

Matthew Stephen Herzig, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1508447111
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
293429 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5491
Phone
(617) 667-7000
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 293429 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5491

Mailing address

4414 Locust St
Philadelphia, PA 19104-2923
Phone (781) 915-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829002661 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6709260557

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
293429MAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mherzig253989@direct.bilh.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1508447111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042923",
            "telephone_number": "781-915-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZIG",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "293429",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.