Individual provider Active NPI

Spencer Jake Herman

  • Veterinarian
  • New York, NY
National Provider Identifier
1558732610
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
013570 Issued in NY
Practice address
417 E 72ND St Apt 1a
New York, NY 10021-4415
Phone
(917) 675-6270
Fax
(917) 675-7494
NPI assigned
Oct 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 013570 NY Primary

Addresses

Primary practice location

417 E 72ND St Apt 1a
New York, NY 10021-4415

Mailing address

417 E 72ND St Apt 1a
New York, NY 10021-4415
Phone (917) 675-6270

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
013570NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1558732610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E 72ND ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214415",
            "telephone_number": "917-675-6270",
            "fax_number": "917-675-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E 72ND ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214415",
            "telephone_number": "917-675-6270",
            "fax_number": "917-675-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "SPENCER",
        "middle_name": "JAKE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NY",
            "license": "013570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.