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LAWRENCE J HERBERHOLZ MD
NPI 1619977378
Surgery in Scottsboro, AL

Active since July 26, 2005PECOS EnrolledAccepts Medicare Assignment
14.47/100
CMS Quality Rating
911 S BROAD ST, SCOTTSBORO, AL 35768(256) 259-0185(256) 259-0317 Get Directions Write a Review

NPPES record last updated: February 6, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lawrence J Herberholz Md NPPES

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

LAWRENCE J HERBERHOLZ MD (NPI 1619977378) is an individual surgery provider in Scottsboro, Alabama, licensed in Alabama (23961) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (1992).

NPPES Registry Identity

NPI1619977378
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameLAWRENCE J HERBERHOLZCredential: MD
Location Address911 S BROAD STScottsboro, AL 35768-2509
Mailing Address911 S Broad StScottsboro, AL 35768-2509 · (256) 259-0185 · Fax (256) 259-0317
Phone(256) 259-0185
Fax(256) 259-0317
Sole ProprietorYes
Medical School CMSWayne State University School Of MedicineGraduated 1992
Enumeration DateJuly 26, 2005
Last NPPES UpdateFebruary 6, 2013
✔ NPI 1619977378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in AL · 23961
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
911 S BROAD ST, Scottsboro, AL 35768
Open in Google Maps ↗

Other Identifiers 5

Medicare UPING-94649
Medicaid009990335AL
Medicare PIN51524140AL
Medicaid529923150AL
Other51524140Blue Cross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lawrence J Herberholz Md 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 ID6901861673
PECOS Enrollment IDI20041122000765
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.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
75 services66 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
66 services66 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This 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.
66 services52 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
53 services49 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
42 services42 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
39 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35768 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

14.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost48.23

Other Providers at the Same Location NPPES 2

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

EDWARD WESLEY KNOWLES M.D.
Surgery
911 S BROAD ST
SCOTTSBORO, AL 35768
Jackson County (256) 259-0185
LAWRENCE J HERBERHULZ MD, PC
Surgery
911 S BROAD ST
SCOTTSBORO, AL 35768
Jackson County (256) 259-0185

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 Lawrence Herberholz's NPI number?

The NPI number for Lawrence Herberholz is 1619977378. It was assigned to this individual provider in the NPPES registry on July 26, 2005.

Where is Lawrence Herberholz located?

Lawrence Herberholz practices at 911 S Broad St, Scottsboro, AL 35768. The listed phone number is (256) 259-0185.

What is Lawrence Herberholz's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Lawrence Herberholz enrolled in Medicare?

Yes. Lawrence Herberholz 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.

What insurance does Lawrence Herberholz accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Lawrence Herberholz 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.

When was this NPI record last updated?

The NPPES record for Lawrence Herberholz was last updated on February 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.