Active NPI
Leah Nicole Herzog, M.D.
- Surgery Physician
- Charleston, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 38589
- Practice address
- 169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905 - Phone
- (843) 792-3072
- NPI assigned
- Jun 28, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 38589 | SC | Primary |
Addresses
Primary practice location
169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Mailing address
169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Phone (843) 792-3072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Drexel University College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12200 Warwick Blvd
Suite 490
Newport News, VA 23601-2548
Phone (757) 534-6380
Hospital & facility affiliations
- Riverside Regional Medical Center
- Riverside Doctors' Hospital of Williamsburg
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38589 | SC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vahey & Gluck Hand Surgery, LTD | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Riverside Physician Services, Inc. | Surgery | Current | Accepting new patients |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Riverside Physician Services Inc | Past | Accepting new patients |
Locations
8585 S Eastern Ave
Ste 100
Las Vegas, NV 89123
Phone (702) 798-8585
858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343
856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900
12200 Warwick Blvd
Ste 490
Newport News, VA 23601
Phone (757) 534-5600
Interoperability endpoints
- lherzog236222@direct.rivhs.com
Organizations & group practices 5
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.
-
- Gastroenterology Physician
- Newport News, VA
- NPI 1194929026
-
- Orthopaedic Hand Surgery Physician
- Las Vegas, NV
- NPI 1740446558
-
- Gastroenterology Physician
- Williamsburg, VA
- NPI 1083867311
-
- Family Medicine Physician
- Newport News, VA
- NPI 1710020623
Surgery
-
- Family Medicine Physician
- Newport News, VA
- NPI 1013933977
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Williamsburg, VA
- NPI 1275893307
-
- General Acute Care Hospital
- Newport News, VA
- NPI 1366547747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435449600000",
"number": "1780066530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-3072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-3072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZOG",
"first_name": "LEAH",
"middle_name": "NICOLE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-28",
"last_updated": "2015-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "38589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.