Godofredo M Herzog, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME21751 Issued in FL

Practice address

5640 Marquesas Cir
Sarasota, FL 34233-3331

Phone

(941) 921-5741

Fax

(941) 927-5746

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sarasota Medical Clinic PA

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Sarasota, FL
  • NPI 1760415574
  Medicare reassignment NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811913445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 MARQUESAS CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333331",
            "telephone_number": "941-921-5741",
            "fax_number": "941-927-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 MARQUESAS CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342333331",
            "telephone_number": "941-921-5741",
            "fax_number": "941-927-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "GODOFREDO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME21751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE COSS BLUE SHIELD",
            "identifier": "11001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Herron, DC
• Richard Christian Hershberger, MD
• Ligaya Buchbinder Hershman, MD
• Christine Hertz, RNFA
• Adrienne Lawton Hery, MD
• Adrianna Corona Hess, ED.S
• Marie Christine Hetu, PSYD
• Abbie Heupel, PA
• William Charles Heymann, M.D.
• Christopher Lowe Hicklin, DC

• General Practice Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.