SHANTI ELIZABETH HERZOG FNP
NPI 1770959025
Nurse Practitioner - Family in Tumwater, WA
NPI Status: Active since August 20, 2015
Contact Information
6334 LITTLEROCK RD SW
TUMWATER, WA
ZIP 98512
Phone: (360) 704-7590
Fax: (360) 704-7591
- Individual
- Female
- Nurse Practitioner
- Family
- Accepts Insurance
- Opted-Out Medicare
About SHANTI HERZOG
This page provides the complete NPI Profile along with additional information for Shanti Herzog, a provider established in Tumwater, Washington with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1770959025 assigned on August 2015. The practitioner's primary taxonomy code is 363LF0000X with license number AP60791095 (WA). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1770959025
- Provider Name
- SHANTI ELIZABETH HERZOG FNP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 6334 LITTLEROCK RD SW TUMWATER, WA 98512
- Location Phone
- (360) 704-7590
- Location Fax
- (360) 704-7591
- Mailing Address
- 2101 E YESLER WAY STE 210 SEATTLE, WA 98122
- Mailing Phone
- (503) 988-7468
- Mailing Fax
- (360) 704-7591
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-20-2015
- Last Update Date
- 12-11-2020
- Code Navigator
A nurse practitioner (NP) like Shanti Herzog is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
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. Shanti Herzog opted out of Medicare effective on 04-01-2025 until 04-01-2027. 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 and cannot order and refer services to other healthcare providers.
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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- AP60791095
- License State
- WA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Core Standard Gold - EPO
- Core Standard Silver - EPO
- PacificSource Oregon Standard Bronze HSA Plan Core - EPO
- PacificSource Oregon Standard Gold Plan Core - EPO
- PacificSource Oregon Standard Silver Plan Core - EPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
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 |
|---|---|---|---|
| 22959 | MEDICAID (05) | OR | |
| 096511 | MEDICAID (05) | OR |
Medicare Participation & PECOS Enrollment Status
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.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2025
Opt-Out End Date: 04-01-2027
Eligible to Order and Refer? No
Reviews for SHANTI ELIZABETH HERZOG FNP
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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 1770959025, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
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 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
TUMWATER, WA 98512
TUMWATER, WA 98512
TUMWATER, WA 98512
TUMWATER, WA 98512
TUMWATER, WA 98512
TUMWATER, WA 98512
TUMWATER, WA 98512
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770959025, enumerated as an "individual" on August 20, 2015.
The provider is located at 6334 LITTLEROCK RD SW TUMWATER, WA 98512 and the phone number is (360) 704-7590.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: PacificSource Health Plans, Premera Blue Cross. Please consult your insurance carrier or call the provider to verify.
