Organization Active NPI

Peter Hertzak, M.D., PMC

  • Plastic Surgery Physician
  • Slidell, LA
National Provider Identifier
1821156175
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
05273R Issued in LA
Legal business name
PETER HERTZAK, M.D., PMC
Practice address
985 Robert Blvd.
Suite 105
Slidell, LA 70458
Phone
(985) 641-6300
Fax
(985) 646-1409
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Karen R Motes
Title
Office Manager
Phone
(985) 690-8349

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 05273R LA
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 05273R LA Primary

Addresses

Primary practice location

985 Robert Blvd.
Suite 105
Slidell, LA 70458

Mailing address

985 Robert Blvd.
Suite 105
Slidell, LA 70458
Phone (985) 641-6300

Other identifiers 1

IdentifierTypeStateIssuer
1311308MedicaidLA

National Provider Directory

National Provider Directory

Locations

985 Robert Blvd
Ste 105
Slidell, LA 70458
Phone (985) 646-2303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821156175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD.",
            "address_2": "SUITE 105",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-641-6300",
            "fax_number": "985-646-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD.",
            "address_2": "SUITE 105",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-641-6300",
            "fax_number": "985-646-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER HERTZAK, M.D., PMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOTES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-690-8349",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "05273R",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "LA",
            "license": "05273R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311308",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.