MICHAEL ANTHONY HERZIK M.D.
NPI 1801207873
Internal Medicine in San Antonio, TX

Active since May 13, 2014PECOS EnrolledAccepts Medicare Assignment
12446 WEST AVE STE 200, SAN ANTONIO, TX 78216(210) 525-1668 Get Directions Write a Review

NPPES record last updated: February 25, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Michael Anthony Herzik M.d. NPPES

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

MICHAEL ANTHONY HERZIK M.D. (NPI 1801207873) is an individual internal medicine provider in San Antonio, Texas, licensed in Texas (R2619) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospital, and maintains a secondary practice location in San Antonio.

NPPES Registry Identity

NPI1801207873
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMICHAEL ANTHONY HERZIKCredential: M.D.
Location Address12446 WEST AVE STE 200San Antonio, TX 78216-2530
Mailing Address7330 San Pedro AveSan Antonio, TX 78216-6235 · (210) 344-2673 · Fax (210) 344-2649
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMay 13, 2014
Last NPPES UpdateFebruary 25, 2019
✔ NPI 1801207873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in TX · R2619✔ Licensed in MS · T-2807
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12446 WEST AVE STE 200, San Antonio, TX 78216

Secondary Practice Location 1

Location 18026 Floyd Curl DrSan Antonio, TX 78229-3915 · Phone (210) 562-0037

Other Identifiers 1

Medicaid377321003TX

Accepted 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

Michael Anthony Herzik M.d. 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 ID4587981485
PECOS Enrollment IDI20171027001174
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 4

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-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.
594 services144 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.
402 services132 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
162 services148 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial 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.
79 services75 patients

Hospital Affiliations CMS Care Compare 2

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

Methodist Hospital

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450388
Location7700 Floyd Curl DrSan Antonio, TX 78229 · Bexar County
Emergency services Birthing friendly

Methodist Hospital Stone Oak

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number670055
Location1139 E Sonterra Blvd,San Antonio, TX 78258 · Bexar County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78216 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%189 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers29 claims29 services$71.46 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$28.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

Internal Medicine (Pulmonary Disease)
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Hospitalist
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Internal Medicine
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Nurse Practitioner (Acute Care)
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Nurse Practitioner (Family)
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Internal Medicine
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Internal Medicine (Pulmonary Disease)
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216
Pediatrics (Neonatal-Perinatal Medicine)
12446 WEST AVE STE 200
SAN ANTONIO, TX 78216

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 Michael Herzik's NPI number?

The NPI number for Michael Herzik is 1801207873. It was assigned to this individual provider in the NPPES registry on May 13, 2014.

Where is Michael Herzik located?

Michael Herzik practices at 12446 West Ave Ste 200, San Antonio, TX 78216. The listed phone number is (210) 525-1668.

What is Michael Herzik's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Michael Herzik enrolled in Medicare?

Yes. Michael Herzik 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 Michael Herzik accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Michael Herzik 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 Michael Herzik affiliated with any hospitals?

According to CMS data, Michael Herzik is affiliated with Methodist Hospital and Methodist Hospital Stone Oak.

When was this NPI record last updated?

The NPPES record for Michael Herzik was last updated on February 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.