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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MADELINE R HERRERA DO
NPI 1427679026
Obstetrics & Gynecology in Lawrenceville, GA

Active since May 05, 2020PECOS Enrolled
500 MEDICAL CENTER BLVD STE 190, LAWRENCEVILLE, GA 30046(770) 643-4115(678) 377-3820 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 27, 2026, Apr 14, 2026, Sep 17, 2024 and 2 more (5 updates tracked since 2020).

About Dr. Madeline R Herrera Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MADELINE R HERRERA DO (NPI 1427679026) is an individual obstetrics & gynecology provider in Lawrenceville, Georgia, licensed in Georgia (111681) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Grosse Pointe, and is a graduate of Philadelphia Col Of Osteo Med, Sewanee (2020).

NPPES Registry Identity

NPI1427679026
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. MADELINE R HERRERACredential: DO
Location Address500 MEDICAL CENTER BLVD STE 190Lawrenceville, GA 30046-3379
Mailing Address500 Medical Center Blvd Ste 190Lawrenceville, GA 30046-3379 · (770) 643-4115 · Fax (678) 377-3820
Phone(770) 643-4115
Fax(678) 377-3820
Sole ProprietorNo
Medical School CMSPhiladelphia Col Of Osteo Med, SewaneeGraduated 2020
Enumeration DateMay 5, 2020
Last NPPES UpdateOctober 23, 20265 updates tracked since enumeration
NPPES CertifiedOctober 23, 2026
✔ NPI 1427679026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in GA · 111681
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
500 MEDICAL CENTER BLVD STE 190, Lawrenceville, GA 30046
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan, Ambetter from Meridian and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Madeline R Herrera Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193156768
PECOS Enrollment IDI20240814001006
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Madeline Herrera reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gwinnett Physician Group, LLC
0.2 mi
Internal Medicine
1000 MEDICAL CENTER BLVD, MOB 100 SUITE 210
Lawrenceville, GA 30046
  • Reassigned Medicare billing, Georgia enrollment
  • 275 clinicians in this Medicare group
NPI 1578574661 (855) 709-4535
Ascension St John Hospital
586 mi
Neurology
22101 MOROSS RD
Detroit, MI 48236
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Henry Ford Health St. John Hospital
  • 520 clinicians in this Medicare group
NPI 1023149473 (586) 753-0011
Together Women's Health Medical Group, P.C.
593 mi
Obstetrics & Gynecology
29751 LITTLE MACK AVE, SUITE B
Roseville, MI 48066
  • Reassigned Medicare billing, Michigan enrollment
  • 99 clinicians in this Medicare group
NPI 1750415915 (586) 415-6200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230089
Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County
Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GINA R HARRIS D.O.
Obstetrics & Gynecology
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115
TONYA MARIE HEMMINGS CNM
Advanced Practice Midwife
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115
DR. MAHELATE THEODROS DO
Obstetrics & Gynecology
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115
DR. MELANIE ERIN WATKINS MD
Obstetrics & Gynecology
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115
FAUZIYA ALI MALANI RN, APRN, FNP/ENP
Nurse Practitioner (Family)
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-3290
RIA MERCY RICHARDS MD
Obstetrics & Gynecology
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115
DR. KATIE ELIZABETH TUGGLE M.D.
Obstetrics & Gynecology
500 MEDICAL CENTER BLVD STE 190
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 643-4115

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Madeline Herrera's NPI number?

The NPI number for Madeline Herrera is 1427679026. It was assigned to this individual provider in the NPPES registry on May 5, 2020.

Where is Madeline Herrera located?

Madeline Herrera practices at 500 Medical Center Blvd Ste 190, Lawrenceville, GA 30046. The listed phone number is (770) 643-4115.

What is Madeline Herrera's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Madeline Herrera enrolled in Medicare?

Yes. Madeline Herrera is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Madeline Herrera's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madeline Herrera reassigns Medicare benefits to 3 organizations: Gwinnett Physician Group, LLC (Lawrenceville, GA), Ascension St John Hospital (Detroit, MI) and Together Women's Health Medical Group, P.C. (Roseville, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Madeline Herrera's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Madeline Herrera accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Ambetter of Alabama and 7 other insurers list Madeline Herrera as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Madeline Herrera affiliated with any hospitals?

According to CMS data, Madeline Herrera is affiliated with Beaumont Hospital - Grosse Pointe and Ascension St John Hospital.

When was this NPI record last updated?

The NPPES record for Madeline Herrera was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.