HAZEN TIMOTHY HERZOG PHYSICIAN ASSISTANT
NPI 1932433190
Physician Assistant - Surgical in Coos Bay, OR

Q: What is Hazen Herzog's NPI number?

The NPI number for Hazen Herzog is 1932433190. It was assigned to this individual provider in the NPPES registry on September 21, 2009.

Q: What is Hazen Herzog's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Hazen Herzog was last updated on November 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 September 21, 2009PECOS EnrolledAccepts Medicare Assignment

83.32/100

CMS Quality Rating

1900 WOODLAND DR, COOS BAY, OR 97420(541) 267-5151(541) 266-4501 Get Directions Write a Review

NPPES record last updated: November 8, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Hazen Timothy Herzog Physician Assistant NPPES

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

HAZEN TIMOTHY HERZOG PHYSICIAN ASSISTANT (NPI 1932433190) is an individual surgical provider in Coos Bay, Oregon, licensed in Oregon (PA152638) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1932433190

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameHAZEN TIMOTHY HERZOGCredential: PHYSICIAN ASSISTANT

Location Address1900 WOODLAND DRCoos Bay, OR 97420-2045

Mailing Address1900 Woodland DrCoos Bay, OR 97420-2045 · (541) 267-5151 · Fax (541) 266-4501

Phone(541) 267-5151

Fax(541) 266-4501

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateSeptember 21, 2009

Last NPPES UpdateNovember 8, 2013

✔ NPI 1932433190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in OR · PA152638

Also ListedPhysician AssistantTaxonomy 363A00000X · License 7462373-1206 (UT)

1900 WOODLAND DR, Coos Bay, OR 97420

Open in Google Maps ↗

Other Identifiers 9

Other1407812365OR · Group Npi North Bend Medical Center

Other161133OR · Group Medicaid North Bend Medical Center

Other93-0635514OR · Group Tax For Billing North Bend Medical Center

OtherR000WFBTVOR · Group Medicare North Bend Medical Center

Other74623731206UT · License

OtherPA152638OR · Medical License

Medicaid500625533OR

OtherP01220506OR · Railroad Medicare

Medicare PINR155058OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.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

Hazen Timothy Herzog Physician Assistant 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 ID2062550387

PECOS Enrollment IDI20170407001260

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 3

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 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.

47 services38 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services12 patients

Repair of hernia of muscle at esophagus and stomach using an endoscope 43281

This procedure fixes a hernia, an area where your stomach and esophagus muscles have weakened. Using an endoscope, a thin tube with a camera, the doctor can see and repair the hernia without large incisions, promoting quicker recovery.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130002

Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County

Emergency services Birthing friendly

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130071

Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County

Emergency services Birthing friendly

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.

83.32/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.51

Promoting Interoperability

100

Improvement Activities

Cost

64.88

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.

CAITLIN O'REILLY

Physical Therapist

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

CHLOE NICOLE LEIBY PT, DPT

Physical Therapist

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

BHAVANI PEDDAGOVINDU MD

Internal Medicine

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

DR. MAYNIKA VANI RASTOGI MD

Pediatrics

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

LISA M BOYLE RPH

Pharmacist

1900 WOODLAND DR, SUITE A
COOS BAY, OR 97420

Coos County (541) 267-4815

SHARON ELAINE MONSIVAIS M.D.

Surgery (Plastic and Reconstructive Surgery)

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

DR. DONNA LEE RABIN MD

Pediatrics

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

MR. GREGORY SOPKA PA

Physician Assistant

1900 WOODLAND DR
COOS BAY, OR 97420

Coos County (541) 267-5151

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 Hazen Herzog's NPI number?

The NPI number for Hazen Herzog is 1932433190. It was assigned to this individual provider in the NPPES registry on September 21, 2009.

Where is Hazen Herzog located?

Hazen Herzog practices at 1900 Woodland Dr, Coos Bay, OR 97420. The listed phone number is (541) 267-5151.

What is Hazen Herzog's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Hazen Herzog enrolled in Medicare?

Yes. Hazen Herzog 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 Hazen Herzog accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan list Hazen Herzog 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 Hazen Herzog affiliated with any hospitals?

According to CMS data, Hazen Herzog is affiliated with St Lukes Magic Valley Medical Center, St Luke's Regional Medical Center and St Luke's Nampa Medical Center.

When was this NPI record last updated?

The NPPES record for Hazen Herzog was last updated on November 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.