DR. JOHN PETER HERZOG D.O.
NPI 1265642425
Orthopaedic Surgery in Falmouth, ME
NPI Status: Active since May 23, 2007
Contact Information
98 CLEARWATER DR
SUITE 4
FALMOUTH, ME
ZIP 04105
Phone: (207) 781-9077
Fax: (207) 347-8285
- Individual
- Male
- Orthopaedic Surgery
- Accepts Insurance
- PECOS Enrolled
About JOHN HERZOG
This page provides the complete NPI Profile along with additional information for John Herzog, a provider established in Falmouth, Maine with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1265642425 assigned on May 2007. The practitioner's primary taxonomy code is 207X00000X with license number 1107 (ME). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1265642425
- Provider Name
- DR. JOHN PETER HERZOG D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 98 CLEARWATER DR SUITE 4 FALMOUTH, ME 04105
- Location Phone
- (207) 781-9077
- Location Fax
- (207) 347-8285
- Mailing Address
- 98 CLEARWATER DR SUITE 4 FALMOUTH, ME 04105
- Mailing Phone
- (207) 781-9077
- Mailing Fax
- (207) 347-8285
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-23-2007
- Last Update Date
- 07-22-2009
- Code Navigator
Location Map
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
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 1107
- License State
- ME
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
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 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - 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%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E13872 | MEDICARE UPIN (02) | ||
| HE015762 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
John Herzog 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
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.
Aspiration and/or injection of fluid large joint using ultrasound guidance
Complete ultrasound scan of joint
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection, methylprednisolone acetate, 80 mg
New patient office or other outpatient visit, 45-59 minutes
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
This service was performed 78 times for 45 patientsA complete ultrasound scan of a joint is a non-invasive procedure using sound waves to create images of your joint. It helps identify problems like inflammation, injury, or disease. It's painless, safe, and doesn't involve radiation.
This service was performed 29 times for 21 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 34 times for 29 patientsThis 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 13 times for 12 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 128 times for 66 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 43 times for 43 patientsPhysician Visit Costs
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 04105 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $86.72
- Minimum New Patient Price $56.28
- Maximum New Patient Price $169.96
- Average New Patient Copayment $21.68
- Minimum New Patient Copayment $14.07
- Maximum New Patient Copayment $42.49
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.13
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $138.92
- Average Established Patient Copayment $17.53
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $34.73
* 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.
Reviews for DR. JOHN PETER HERZOG D.O.
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NPI Validation Check Digit Calculation
The following table explains the step by step 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 | 2 | 6 | 5 | 6 | 4 | 2 | 4 | 2 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 12 | 4 | 4 | 4 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 1 + 2 + 4 + 4 + 4 + 4 + 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 1265642425 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 6 providers are registered at the same or nearby location.
EDGEWATER ORTHOPEDIC PHYSICAL THERAPY, LLC
Physical Therapist
98 CLEARWATER DR
SUITE 3
FALMOUTH, ME
ZIP 04105
ORTHOPEDIC SPECIALISTS, LLC
Orthopaedic Surgery
98 CLEARWATER DR
FALMOUTH, ME
ZIP 04105
DR. KEELYN WU DO
Neuromusculoskeletal Medicine & OMM
98 CLEARWATER DR
FALMOUTH, ME
ZIP 04105
DR. JENNIFER VANDERZEE HILTON D.O.
Neuromusculoskeletal Medicine & OMM
98 CLEARWATER DR
SUITE ONE
FALMOUTH, ME
ZIP 04105
OSTEOPATHIC HEALTHCARE OF MAINE, P.A.
Neuromusculoskeletal Medicine & OMM
98 CLEARWATER DR
FALMOUTH, ME
ZIP 04105
MARIE DARDENO DO
Family Medicine
98 CLEARWATER DR
FALMOUTH, ME
ZIP 04105
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265642425, enumerated as an "individual" on May 23, 2007.
The provider is located at 98 CLEARWATER DR SUITE 4 FALMOUTH, ME 04105 and the phone number is (207) 781-9077.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
