Shawn Barton Hersevoort, M.D., M.P.H.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A88489 Issued in CA

Practice address

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151

Phone

(877) 768-7075

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Psychiatry

Education

Tulane University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: lifestancehealthcalifornia.shawnhersevoort@148377.advancedmd-direct.com

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.

• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA, Psychiatry

  Medicare reassignment Care Compare group NPD
• Alliance Mental Health

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1235368234
  NPD (past) Authorized official
• Psycare Inc

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1811927106
  NPD
• Bay Psychiatric Associates

  • Psychiatry Physician
  • Berkeley, CA
  • NPI 1427163229
  NPD (past)
• Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1992742852
  NPD (past)
• University Faculty Associates, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1235537283
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1518013317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "877-768-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "877-768-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSEVOORT",
        "first_name": "SHAWN",
        "middle_name": "BARTON",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-02-09",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A88489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Herrera
• Joanna Herrera
• Madeleine Ann Herrera, RN
• Herrick Campus Pharmacy
• Bernard D. Herring, M.D.
• Shannon K Hervey-Lentz
• Abby Herzberg
• Genesee Herzberg, PSY.D.
• Judye Gershman Hess, PH.D.
• Kirk Alan Hewett, LMFT

• Psychiatry Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.