MR. ROBERT HERZOG PA
NPI 1902963614
Physician Assistant in Carbondale, IL

Q: What is Robert Herzog's NPI number?

The NPI number for Robert Herzog is 1902963614. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Q: What is Robert Herzog's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Herzog was last updated on October 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since January 02, 2007PECOS EnrolledAccepts Medicare Assignment

2601 W MAIN ST, CARBONDALE, IL 62901(618) 549-5361(618) 351-4878 Get Directions Write a Review

NPPES record last updated: October 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 13, 2023, Oct 24, 2022, Sep 16, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Mr. Robert Herzog Pa NPPES

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

MR. ROBERT HERZOG PA (NPI 1902963614) is an individual physician assistant in Carbondale, Illinois, licensed in Illinois (085-002116) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Marshall Browning Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1902963614

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. ROBERT HERZOGCredential: PA

Location Address2601 W MAIN STCarbondale, IL 62901-1031

Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200

Phone(618) 549-5361

Fax(618) 351-4878

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateJanuary 2, 2007

Last NPPES UpdateOctober 13, 20234 updates tracked since enumeration

NPPES CertifiedOctober 11, 2023

✔ NPI 1902963614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085-002116

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2601 W MAIN ST, Carbondale, IL 62901

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Secondary Practice Locations 4

Location 1900 N Washington StDu Quoin, IL 62832-1233 · Phone (618) 542-1050

Location 2502 W Saint Louis St Ste 4West Frankfort, IL 62896-1968 · Phone (618) 937-3400 · Fax (618) 997-9324

Location 3405 Rushing DrHerrin, IL 62948-3730 · Phone (618) 993-3000 · Fax (618) 993-0262

Location 4905 N Washington StreetDu Quoin, IL 62832-6283 · Phone (618) 542-1050

Other Identifiers 5

Other086861IL · Hamp Ins. Number

Other086861IL · Ghp

Other7210895IL · Aetna

Other3932056IL · Bcbs Of Il

Other619456IL · Healthlink

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

Mr. Robert Herzog Pa 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 ID6507758067

PECOS Enrollment IDI20040329000648

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.

Hospital Affiliations CMS Care Compare

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

Marshall Browning Hospital

Critical Access Hospitals · Du Quoin, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141331

Location900 North Washington StreetDu Quoin, IL 62832 · Perry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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 20

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

MELISSA A MARTINEZ MATEO M.D.

Internal Medicine (Gastroenterology)