Charles Schaeffer Hertz Jr., M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD2011-0092 Issued in NM

Practice address

1691 Galisteo St
Suite C
Santa Fe, NM 87505-4780

Phone

(505) 983-5631

Fax

(505) 982-5605

NPI assigned

May 17, 2006

Last updated

Jul 27, 2011By the provider in NPPES

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Skyline Endoscopy Center, L.L.C.

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  • Jackson, TN
  • NPI 1437373248
  NPD (past) Authorized official
• Medical Specialty Clinic P.C.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1104877703

  Gastroenterology

  NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1609828326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-983-5631",
            "fax_number": "505-982-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "CHARLES",
        "middle_name": "SCHAEFFER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "13380",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD2011-0092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100006289",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "4748210",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "53765",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3187049",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4466329",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC PROVIDER NUMBER",
            "identifier": "8160",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Denae Herrera
• Martin A Herrera
• Michael Dennis Herrera, O.D.
• Oscar Herrera, CSW
• Clinton Herring, CASE MANAGER ACT
• Susan M Heumiller, LPC, LPCC
• Elisabeth Egan Hickok, LPC
• Debra K Higginbotham, MD
• Barbara Carmen Higgins, D.O.M.
• Donald Keith Higgins

• Gastroenterology Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Gastroenterology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.