Active NPI
Lee J Herskowitz, D.O.
- Pediatrics Physician
- Salem, OR
National Provider Identifier
1780728956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DO22759
- Practice address
- 1233 Edgewater St NW
Salem, OR 97304-4049 - Phone
- (503) 378-7526
- Fax
- (503) 585-4278
- NPI assigned
- Feb 19, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DO22759 | OR | Primary |
Addresses
Primary practice location
1233 Edgewater St NW
Salem, OR 97304-4049
Mailing address
1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023015 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1780728956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973044049",
"telephone_number": "503-378-7526",
"fax_number": "503-585-4278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973044049",
"telephone_number": "503-378-7526",
"fax_number": "503-585-4278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSKOWITZ",
"first_name": "LEE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "DO22759",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023015",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.