NPIMap

Organization Active NPI

John C. Herzog, DO, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Saratoga Springs, NY
National Provider Identifier
1861992281
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
214382 Issued in NY
Legal business name
JOHN C. HERZOG, DO, PLLC
Practice address
31 Myrtle St
Saratoga Springs, NY 12866-1036
Phone
(518) 587-7746
Fax
(518) 306-6502
NPI assigned
Feb 13, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHN C. HERZOG, DO, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Authorized official

Name
Lauren Fields
Title
Practice Manager
Phone
(518) 587-7746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 214382 NY Primary

Addresses

Primary practice location

31 Myrtle St
Saratoga Springs, NY 12866-1036

Mailing address

PO Box 819
Saratoga Springs, NY 12866-0819
Phone (518) 587-7746

Other identifiers 1

IdentifierTypeStateIssuer
1255377438MedicaidNY

National Provider Directory

National Provider Directory
Part of
John C Herzog DO PLLC

Locations

4 Emma Ln
Ste B
Clifton Park, NY 12065
Phone (518) 348-1010

31 Myrtle St
Ste 1
Saratoga Springs, NY 12866
Phone (518) 587-7746

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1861992281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 819",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128660819",
            "telephone_number": "518-587-7746",
            "fax_number": "518-306-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MYRTLE ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661036",
            "telephone_number": "518-587-7746",
            "fax_number": "518-306-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. HERZOG, DO, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN C. HERZOG, DO, PLLC",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "518-587-7746"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "214382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255377438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.