DIEGO ANDRES ADRIANZEN HERRERA M.D.
NPI 1114367463
Internal Medicine - Hematology & Oncology in Burlington, VT
NPI Status: Active since July 01, 2013
Contact Information
111 COLCHESTER AVE
BURLINGTON, VT
ZIP 05401
Phone: (802) 847-0000
- Individual
- Male
- Years of Experience 15
- Internal Medicine
- Hematology & Oncology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About DIEGO ADRIANZEN HERRERA
This page provides the complete NPI Profile along with additional information for Diego Adrianzen Herrera, an internist established in Burlington, Vermont with a medical specialization in Internal Medicine, focusing in hematology & oncology and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1114367463 assigned on July 2013. The practitioner's primary taxonomy code is 207RH0003X with license number 042-0014213 (VT). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1114367463
- Provider Name
- DIEGO ANDRES ADRIANZEN HERRERA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 111 COLCHESTER AVE BURLINGTON, VT 05401
- Location Phone
- (802) 847-0000
- Mailing Address
- 515 W 59TH ST APT.10J NEW YORK, NY 10019
- Mailing Phone
- (914) 414-9685
- Medical School Name
- OTHER
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-01-2013
- Last Update Date
- 04-15-2019
- Code Navigator
An internist like Diego Adrianzen Herrera is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 515 W 59th St Apt. 10J
New York, NY 10019
(914) 414-9685
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Hematology & Oncology
- Taxonomy Code
- 207RH0003X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 042-0014213
- License State
- VT
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Diego Adrianzen Herrera is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Diego Adrianzen Herrera 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3476880196
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20190802002305
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Initial hospital inpatient care per day, typically 70 minutes
Mechanical separation of plasma from blood
New patient office or other outpatient visit, 60-74 minutes
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 95 times for 77 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 346 times for 118 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 83 times for 26 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 25 times for 25 patientsMechanical separation of plasma from blood is a procedure where your blood is drawn and placed in a machine. This machine spins the blood at high speeds, separating the plasma (a yellowish fluid) from the rest of the blood components. The plasma is then collected for medical purposes.
This service was performed 21 times for 11 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 30 times for 30 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $42.12 for a new patient copayment and $24.6 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 05401 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $168.48
- Minimum New Patient Price $55.8
- Maximum New Patient Price $168.48
- Average New Patient Copayment $42.12
- Minimum New Patient Copayment $13.95
- Maximum New Patient Copayment $42.12
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.4
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.84
- Average Established Patient Copayment $24.6
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.46
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Diego Adrianzen Herrera is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR | 75 BEEKMAN STREET PLATTSBURGH, NY 12901 | (518) 562-7767 | Acute Care Hospitals | |
| CENTRAL VERMONT MEDICAL CENTER | BOX 547 BARRE, VT 05641 | (802) 371-4100 | Acute Care Hospitals | |
| UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE | 111 COLCHESTER AVE BURLINGTON, VT 05401 | (802) 847-0000 | Acute Care Hospitals | |
| COPLEY HOSPITAL | 528 WASHINGTON HIGHWAY MORRISVILLE, VT 05661 | (802) 888-4231 | Critical Access Hospitals | |
| PORTER HOSPITAL, INC | 115 PORTER DRIVE MIDDLEBURY, VT 05753 | (802) 388-4701 | Critical Access Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1114367463, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
BURLINGTON, VT 05401
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114367463, enumerated as an "individual" on July 01, 2013.
The provider is located at 111 COLCHESTER AVE BURLINGTON, VT 05401 and the phone number is (802) 847-0000.
Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
Diego Adrianzen Herrera is affiliated with: CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR, CENTRAL VERMONT MEDICAL CENTER, UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE, COPLEY HOSPITAL and PORTER HOSPITAL, INC.
