Active NPI
Zeva Daniela Herzog, MD
- Family Medicine Physician
- Renton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD61065118
- Practice address
- 3915 Talbot Rd S Ste 200
Renton, WA 98055-5738 - Phone
- (425) 690-3400
- Fax
- (425) 690-0600
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD61065118 | WA | Primary |
Addresses
Primary practice location
3915 Talbot Rd S Ste 200
Renton, WA 98055-5738
Mailing address
3600 Lind Ave SW Ste 100
Renton, WA 98057-4970
Phone (425) 690-2715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2104488 | Medicaid | WA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | zherzong72169@direct.valleymed.org | Direct | |
| FHIR URL | https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3915 Talbot Rd S
Suite 200
Renton, WA 98055-5738
Phone (425) 690-3400
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61065118 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Medical Group-Renton | Family Medicine | Current | Accepting new patients |
| Public Hospital District #1 of King County | Past | Accepting new patients |
Locations
16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971
3915 Talbot Rd S
Ste 401
Renton, WA 98055
Phone (425) 656-4224
3915 Talbot Rd S
Ste 200
Renton, WA 98055
Phone (425) 658-5566
3600 Lind Ave SW
Ste 100
Renton, WA 98057
Interoperability endpoints
- zherzong72169@direct.valleymed.org
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.
-
dba VMC Children's Therapy
- Rehabilitation Hospital Unit
- Renton, WA
- NPI 1811063308
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Valley Medical Center
- General Acute Care Hospital
- Renton, WA
- NPI 1649209230
-
- General Acute Care Hospital
- Renton, WA
- NPI 1619209574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1811488968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 LIND AVE SW STE 100",
"city": "RENTON",
"state": "WA",
"postal_code": "980574970",
"telephone_number": "425-690-2715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 TALBOT RD S STE 200",
"city": "RENTON",
"state": "WA",
"postal_code": "980555738",
"telephone_number": "425-690-3400",
"fax_number": "425-690-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZOG",
"first_name": "ZEVA",
"middle_name": "DANIELA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61065118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2104488",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "zherzong72169@direct.valleymed.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "zherzong72169@direct.valleymed.org",
"address_1": "3915 Talbot Rd S Ste 200",
"city": "Renton",
"state": "WA",
"country_code": "US",
"postal_code": "980555738",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "3915 Talbot Rd S Ste 200",
"city": "Renton",
"state": "WA",
"country_code": "US",
"postal_code": "980555738",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.