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ERICA L HERTZOG PHN
NPI 1942704895
Nurse Practitioner - Psychiatric/Mental Health in Wayzata, MN

Active since March 23, 2018PECOS Enrolled
1120 WAYZATA BLVD E STE 210, WAYZATA, MN 55391(320) 864-1236 Get Directions Write a Review

NPPES record last updated: March 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 9, 2023, Mar 23, 2018 (2 updates tracked since 2018).

About Erica L Hertzog Phn NPPES

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

ERICA L HERTZOG PHN (NPI 1942704895) is an individual psychiatric/mental health provider in Wayzata, Minnesota, licensed in Minnesota (9957) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1942704895
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameERICA L HERTZOGCredential: PHN
Location Address1120 WAYZATA BLVD E STE 210Wayzata, MN 55391-1915
Mailing Address1120 Wayzata Blvd E Ste 210Wayzata, MN 55391-1915 · (952) 443-4600 · Fax (952) 443-4604
Phone(320) 864-1236
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 23, 2018
Last NPPES UpdateMarch 9, 20232 updates tracked since enumeration
NPPES CertifiedMarch 9, 2023
✔ NPI 1942704895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MN · 9957
Also ListedRegistered Nurse · Community HealthTaxonomy 163WC1500X · License R-186114-1 (MN)
1120 WAYZATA BLVD E STE 210, Wayzata, MN 55391
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Erica L Hertzog Phn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072988500
PECOS Enrollment IDI20230413002456
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.

Medicare Billing Reassignment

Medicare enrollment records show Erica Hertzog reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Portages Health LLC
14 mi
Prescribing (Medical)
310 4TH AVE S STE 5010
Minneapolis, MN 55415
  • Reassigned Medicare billing, Minnesota enrollment
  • 8 clinicians in this Medicare group
NPI 1942945761 (320) 492-2232

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55391 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

DEVAN KRISTINE RUBIO LPCC
Counselor (Mental Health)
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
MISS LUCIANA ALEXANDRA DI BIAGIO MSW, LGSW
Student in an Organized Health Care Education/Training Program
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
ELYSE SIMPSON
Student in an Organized Health Care Education/Training Program
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
MEGAN FREDRICKSON MA
Counselor (Professional)
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
JULIA MAY CARPENTER MSW
Social Worker (Clinical)
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
CONNOR MCMANUS
Student in an Organized Health Care Education/Training Program
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
MICHELLE RENEE JARMAN
Nurse Practitioner (Psychiatric/Mental Health)
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600
JONATHAN HESS
Student in an Organized Health Care Education/Training Program
1120 WAYZATA BLVD E STE 210
WAYZATA, MN 55391
Hennepin County (952) 443-4600

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 Erica Hertzog's NPI number?

The NPI number for Erica Hertzog is 1942704895. It was assigned to this individual provider in the NPPES registry on March 23, 2018.

Where is Erica Hertzog located?

Erica Hertzog practices at 1120 Wayzata Blvd E Ste 210, Wayzata, MN 55391. The listed phone number is (320) 864-1236.

What is Erica Hertzog's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Erica Hertzog enrolled in Medicare?

Yes. Erica Hertzog is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Erica Hertzog's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Erica Hertzog reassigns Medicare benefits to Portages Health LLC (Minneapolis, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Erica Hertzog's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Erica Hertzog accept?

Health plans from HealthPartners list Erica Hertzog 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 Erica Hertzog was last updated on March 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.