Active NPI
Paul J Hersch, MD
- Internal Medicine Physician
- Tamarac, FL
National Provider Identifier
1508831504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0014485
- Practice address
- 4959 N State Rd 7
Ste C
Tamarac, FL 33319 - Phone
- (954) 484-8850
- Fax
- (954) 484-8851
- NPI assigned
- Feb 22, 2006
- Last updated
- Sep 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0014485 | FL | Primary |
Addresses
Primary practice location
4959 N State Rd 7
Ste C
Tamarac, FL 33319
Mailing address
4959 N State Rd 7
Ste C
Tamarac, FL 33319
Phone (954) 484-8850
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 245925 | Other | FL | AVMED |
| 5883296 | Other | FL | AETNA |
| 78066 | Other | FL | BLUE CROSS BLUE SHIELD |
| 110716 | Other | FL | HUMANA |
| 061347900 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0014485 | FL | MD | Internal Medicine Physician |
| 14485 | FL | MD | Otology & Neurotology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1508831504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4959 N STATE RD 7",
"address_2": "STE C",
"city": "TAMARAC",
"state": "FL",
"postal_code": "33319",
"telephone_number": "954-484-8850",
"fax_number": "954-484-8851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4959 N STATE RD 7",
"address_2": "STE C",
"city": "TAMARAC",
"state": "FL",
"postal_code": "33319",
"telephone_number": "954-484-8850",
"fax_number": "954-484-8851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSCH",
"first_name": "PAUL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0014485",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "245925",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5883296",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "78066",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "110716",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061347900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.