Active NPI
Zachary Thomas Hertzel, PA
- Physician Assistant
- Lakeland, FL
National Provider Identifier
1851833271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11077377-1206
- Practice address
- 3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965 - Phone
- (863) 603-6565
- Fax
- (863) 904-1961
- NPI assigned
- Nov 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Physician Assistant | 363A00000X | 11077377-1206 | UT | Primary |
Addresses
Primary practice location
3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Mailing address
1324 Lakeland Hills Blvd
Attn: Managed Care Dept.
Lakeland, FL 33805-4543
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | zhertzel355462@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024364 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Florida Em-I Medical Services PA | Past | Accepting new patients |
Locations
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- zhertzel355462@direct.med.utah.edu
Organizations & group practices 4
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.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- Neurological Surgery Physician
- Salt Lake City, UT
- NPI 1144624990
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
-
- Emergency Medicine Physician
- Lakeland, FL
- NPI 1871542720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1851833271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 LAKELAND HILLS BLVD",
"address_2": "ATTN: MANAGED CARE DEPT.",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338054543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338051965",
"telephone_number": "863-603-6565",
"fax_number": "863-904-1961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERTZEL",
"first_name": "ZACHARY",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-16",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "11077377-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "zhertzel355462@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.