Individual provider Active NPI

Thomas James Herbst, MD

  • Psychiatry Physician
  • Ann Arbor, MI
National Provider Identifier
1679571012
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
43010577730 Issued in MI
Practice address
202 E Washington St
Ste 708
Ann Arbor, MI 48104-2017
Phone
(734) 327-9322
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 43010577730 MI Primary
Child & Adolescent Psychiatry Physician 2084P0804X 43010577730 MI

Addresses

Primary practice location

202 E Washington St
Ste 708
Ann Arbor, MI 48104-2017

Mailing address

202 E Washington St
Ste 708
Ann Arbor, MI 48104-2017
Phone (734) 327-9322

Other identifiers 3

IdentifierTypeStateIssuer
260811895-1OtherMIBCBS OF MI PIN
5765659OtherMIAETNA
260811895-2OtherMIBCBS-PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20050106000205 MI Practitioner - Psychiatry 9931157906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

202 E Washington St
Suite 708
Ann Arbor, MI 48104-2017
Phone (734) 327-9322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43010577730MIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas J Herbst MD PLLC CurrentSince Mar 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

202 E Washington St
Ann Arbor, MI 48104
Phone (734) 327-9322

202 E Washington St
Ste 708
Ann Arbor, MI 48104
Phone (734) 327-9322

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1679571012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST",
            "address_2": "STE 708",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-327-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST",
            "address_2": "STE 708",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-327-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "43010577730",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "43010577730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI PIN",
            "identifier": "260811895-1",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5765659",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-PPO",
            "identifier": "260811895-2",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.