Hera OBGYN Medical Group, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

HERA OBGYN MEDICAL GROUP, INC.

Practice address

1552 Coffee Rd
1St Floor
Modesto, CA 95355-3107

Phone

(209) 521-4372

Fax

(209) 523-2005

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Hill

Title

Office Manager

Phone

(209) 521-4372

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 9

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

• Aisha Sabeerau Golaub, MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1134748189
  Medicare reassignment Care Compare group NPD
• Nicholas Holt Hopkins, MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1528414133
  Medicare reassignment Care Compare group NPD
• Casey Elizabeth Richardson

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1124418835
  Medicare reassignment Care Compare group NPD
• Carson Rodeffer, MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1679923387
  Medicare reassignment Care Compare group NPD
• Matthew Laurence Tilstra, MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1235576638
  Medicare reassignment Care Compare group NPD
• Esther June Tow-Der, M.D.

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1427008028
  Medicare reassignment Care Compare group NPD
• Rocio Acera Pozzi, MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1619310737
  Medicare reassignment NPD
• Eduardo Malvin Bueno Lacuna Jr., MD

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1225216393
  Medicare reassignment NPD
• Sarina Cinco Lumapas, MD

  • Obstetrics & Gynecology Physician
  • Cape Coral, FL
  • NPI 1346400306

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1992710768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD",
            "address_2": "1ST FLOOR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553107",
            "telephone_number": "209-521-4372",
            "fax_number": "209-523-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD",
            "address_2": "1ST FLOOR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553107",
            "telephone_number": "209-521-4372",
            "fax_number": "209-523-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERA OBGYN MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "209-521-4372"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ04654Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR01402490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derris Her, B.A.
• Melody Ntixm-Hlub Her
• Nouche Her
• Pangdee Her, OTR/L
• Shoua Her, NP
• Marisol Heras
• Eliseo Antonio Heredia Jr.
• Heritage Care Staffing Services, LLC
• Brian James Herline, DC
• Hermes Guardian Transport

• Obstetrics & Gynecology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.