Keith D Herzog, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD038603E Issued in PA

Practice address

3601 A St
Philadelphia, PA 19134-1043

Phone

(215) 427-6827

Fax

(215) 427-5371

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• STC Pediatrics LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• STC Pediatrics LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1396389805
  NPD
• STC Pediatrics LLC

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997

  Pediatrics

  NPD
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1609800184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 A ST.",
            "address_2": "1-102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341095",
            "telephone_number": "215-427-6827",
            "fax_number": "215-427-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 A ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341043",
            "telephone_number": "215-427-6827",
            "fax_number": "215-427-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "KEITH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD038603E",
            "primary": true
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "PA",
            "license": "MD038603E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001243961-0008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David R. Hertzog, MD
• Jason Herwick
• Joseph Herzig
• Lia Danielle Herzig
• Flavia Marie Herzog, RD,LDN
• Laura Herzog
• Robin Aimee Herzog, MSN, CRNP
• Ruth A. Heslin, RN
• Bryan D Hess, MD
• Joanna Lee Hess, PT, DPT, PRC, WCS

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.