Individual provider Active NPI

Mary Elizabeth Hebert, M.D.

  • Radiation Oncology Physician
  • Nacogdoches, TX
National Provider Identifier
1972547818
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2013045556 Issued in MO
Practice address
4920 NE Stallings Dr
Nacogdoches, TX 75965-1254
Phone
(936) 558-3715
Fax
(936) 558-3701
NPI assigned
Jun 15, 2006
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 2013045556 MO Primary

Addresses

Primary practice location

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254

Mailing address

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254
Phone (936) 558-3715

Other identifiers 6

IdentifierTypeStateIssuer
129804403MedicaidTX
129804405MedicaidTX
129804406MedicaidTX
129804402MedicaidTX
100033980AMedicaidOK
129804404MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040513000739 TX Practitioner - Radiation Oncology 9739179631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of North Carolina at Chapel Hill School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254
Phone (936) 568-3541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013045556MOMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2017 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2017 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients
Texas Oncology PA Radiation Oncology Past Accepting new patients

Locations

631 N Resler Dr
Ste 101
El Paso, TX 79912
Phone (915) 842-0676

4920 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 568-3441

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: mary.hebert.p65@direct.tenet.nextgenshare.com
  • Direct secure messaging: mary.hebert.1@1438.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1972547818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651254",
            "telephone_number": "936-558-3715",
            "fax_number": "936-558-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651254",
            "telephone_number": "936-558-3715",
            "fax_number": "936-558-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2013045556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129804403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129804405",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129804406",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129804402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033980A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129804404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.