DR. THOMAS JAMES HERIZA MD NPI 1083775035
Psychiatry & Neurology (Psychiatry) in Bozeman, MT
NPI Profile for DR. THOMAS JAMES HERIZA MD
Thomas Heriza is a provider established in Bozeman, Montana and his medical specialization is psychiatry & neurology (psychiatry) . The NPI number of Thomas Heriza is 1083775035 and was assigned on December 2006. The practitioner's primary taxonomy code is 2084P0800X with license number 12436 (MT). The provider is registered as an individual and his NPI record was last updated 4 years ago.
A psychiatrist like Dr. Thomas James Heriza Md are primary mental health physicians diagnose and treat mental illnesses through psychotherapy, psychoanalysis, hospitalization and medication. Psychiatrist help patients find solutions through changes in their behavioral patterns, explorations of experiences, group and family therapy.
Thomas Heriza is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices..
Thomas Heriza is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Thomas Heriza opted out of Medicare effective on 09-13-2017 until 09-13-2023. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
| NPI | 1083775035 |
| Provider Name | DR. THOMAS JAMES HERIZA MD |
| Provider Location Address | 1871 S 22ND AVE STE 3 BOZEMAN, MT 59718 |
| Provider Mailing Address | 1871 S. 22ND AVE STE 3 BOZEMAN, MT 59718 |
| Gender | Male |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | Yes |
| Is Organization Subpart? | N/A |
| Enumeration Date | 12-13-2006 |
| Last Update Date | 04-04-2018 |
Primary Taxonomy
| Taxonomy Code | 2084P0800X |
| Classification | Psychiatry & Neurology |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Psychiatry |
| License No. | 12436 |
| License State | MT |
| Taxonomy Description | A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
Business Address
DR. THOMAS JAMES HERIZA MD
1871 S 22ND AVE STE 3
BOZEMAN, MT
ZIP 59718
Phone: (406) 585-3584
Fax: (406) 534-0411
Mailing Address
DR. THOMAS JAMES HERIZA MD
1871 S. 22ND AVE STE 3
BOZEMAN, MT
ZIP 59718
Phone: (406) 585-3584
Fax: (406) 534-0411
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| Opted-Out of Medicare | Yes |
| Opt-Out Effective Date | 09-13-2017 |
| Opt-Out End Date | 09-13-2023 |
| Eligible to Order and Refer | Yes |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 150582 | MEDICAID (05) | OR |
NPI Validation Check Digit Calculation
The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 8 | 3 | 7 | 7 | 5 | 0 | 3 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 16 | 3 | 14 | 7 | 10 | 0 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 6 + 3 + 1 + 4 + 7 + 1 + 0 + 0 + 6 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1083775035 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the same location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1386981678 | REBECCA J POGODA APRN Individual | Nurse Practitioner (Psychiatric/Mental Health) | 1871 S 22ND AVE STE 3 BOZEMAN, MT 59718 (406) 404-6769 |
| 1245284363 | MRS. SUSANNA TURNER DARR APRN Individual | Nurse Practitioner (Psychiatric/Mental Health) | 1871 S 22ND AVE STE 3 BOZEMAN, MT 59718 |
| 1073984019 | JEFF GREEN MD PC Organization | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 1871 S 22ND AVE STE 3 BOZEMAN, MT 59718 (406) 582-9306 |
| 1770522831 | JEFFREY SCOTT GREEN MD Individual | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 1871 S 22ND AVE STE 3 BOZEMAN, MT 59718 (406) 582-9306 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Dr. Thomas James Heriza Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.