Active NPI
Marc Hertzman, M.D.
- Specialist
- Rockville, MD
National Provider Identifier
1689676801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D0016115
- Practice address
- 11404 Old Georgetown Rd
Ste 203
Rockville, MD 20852-2876 - Phone
- (301) 984-8800
- Fax
- (301) 984-8802
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | D0016115 | MD | Primary |
Addresses
Primary practice location
11404 Old Georgetown Rd
Ste 203
Rockville, MD 20852-2876
Mailing address
11404 Old Georgetown Rd
Ste 203
Rockville, MD 20852-2876
Phone (301) 984-8800
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0H18 | Other | MD | BCBS |
| 0087611 | Medicaid | MD | |
| 23880001 | Other | DC | BCBS |
| 325227 | Other | MD | MDIPA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0016115 | MD | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc Hertzman, M.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neurology Physician
- Rockville, MD
- NPI 1477821320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1689676801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11404 OLD GEORGETOWN RD",
"address_2": "STE 203",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208522876",
"telephone_number": "301-984-8800",
"fax_number": "301-984-8802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11404 OLD GEORGETOWN RD",
"address_2": "STE 203",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208522876",
"telephone_number": "301-984-8800",
"fax_number": "301-984-8802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERTZMAN",
"first_name": "MARC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "D0016115",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0H18",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0087611",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "23880001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "325227",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.