Craig Kevin Hertler, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD14722 Issued in OR

Practice address

2222 NW Lovejoy St
Portland, OR 97210-5104

Phone

(503) 222-3638

Fax

(503) 223-5139

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

Yes

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 OR

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

Specialty

Otolaryngology

Education

University of Wisconsin School of Medicine, 1985

Medicare assignment

May accept Medicare assignment

Group practices

PDX ENT and Audiology Medical Group PCGroup PAC ID 8820397086, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• PDX ENT and Audiology Medical Group PC

  • Otolaryngology Physician
  • Portland, OR
  • NPI 1578923751
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1851387146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638",
            "fax_number": "503-223-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638",
            "fax_number": "503-223-5139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17895 NW Evergreen Pkwy Ste 130",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970067402",
            "country_code": "US",
            "telephone_number": "503-222-3638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERTLER",
        "first_name": "CRAIG",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD14722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012893",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally Rollow Hersh, CNM
• Michelle Leigh Hershberger, CADC APPLICANT
• Melissa Paige Hershman, M.D.
• Liban Hersi, QMHA-R
• Tasya Herskovits
• Amber L Hertz-Tang, MD
• Gregory Leonard Hertz, MA
• Margie Elizabeth Hertz, PMHNP-BC
• Kehala Harmony Hervey
• Juliet Marion Herzberg, LCSW

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.

Verify at the official NPI Registry.