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AILEEN HERAS-HERZIG M.D.
NPI 1962545525
Internal Medicine - Endocrinology, Diabetes & Metabolism in Covington, KY

Active since February 14, 2007PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
1500 JAMES SIMPSON JR WAY, SUITE 301, COVINGTON, KY 41011(859) 655-8910(859) 655-8911 Get Directions Write a Review

NPPES record last updated: September 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Aileen Heras-herzig M.d. NPPES

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

AILEEN HERAS-HERZIG M.D. (NPI 1962545525) is an individual endocrinology, diabetes & metabolism provider in Covington, Kentucky, licensed in Kentucky (47754) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, is affiliated with St Elizabeth Dearborn Hospital, and is a graduate of Northwestern University Feinberg Medical School (1997).

NPPES Registry Identity

NPI1962545525
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameAILEEN HERAS-HERZIGCredential: M.D.
Location Address1500 JAMES SIMPSON JR WAY, SUITE 301Covington, KY 41011-0801
Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 655-8910 · Fax (859) 655-8911
Phone(859) 655-8910
Fax(859) 655-8911
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1997
Enumeration DateFebruary 14, 2007
Last NPPES UpdateSeptember 13, 2018
✔ NPI 1962545525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Licenses✔ Licensed in KY · 47754✔ Licensed in WI · 51486
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
1500 JAMES SIMPSON JR WAY, Covington, KY 41011
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Other Names 1

Former Name (1)Aileen Heras- Castro Md

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Aileen Heras-herzig 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 ID2163439043
PECOS Enrollment IDI20150210002048
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 5

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
436 services227 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
63 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
35 services35 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
16 services14 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

St Elizabeth Dearborn Hospital

Acute Care Hospitals · Lawrenceburg, IN
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number150086
Location600 Wilson Creek RdLawrenceburg, IN 47025 · Dearborn County
Emergency services Birthing friendly

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

St Elizabeth Grant

Critical Access Hospitals · Williamstown, KY
OwnershipVoluntary non-profit - Church
CMS Certification Number181311
Location238 Barnes RoadWilliamstown, KY 41097 · Grant County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41011 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
66%127 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
84%141 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
18%219 patients1/55-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 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
26 suppliers100 claims281 services$5.87 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
15 suppliers43 claims80 services$0.98 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
9 suppliers134 claims136 services$190.56 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.

KENNETRA BRADSHAW RD
Dietitian, Registered
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-8910
DR. EUGENE JAMES BURCHELL JR. M.D.
Obstetrics & Gynecology
1500 JAMES SIMPSON JR WAY, WOULD CARE DEPT.
COVINGTON, KY 41011
Kenton County (859) 655-1100
WAEL E EID MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1500 JAMES SIMPSON JR WAY, SUITE 301
COVINGTON, KY 41011
Kenton County (859) 655-8910
MR. ERIC R WOOD PA-C
Physician Assistant
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-1100
MRS. BRIANA L. VITUCCI RD
Dietitian, Registered
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-8910
RAE ELIZAGARAY RD
Dietitian, Registered
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-8910
DR. NED MEHLMAN M.D.
Internal Medicine (Cardiovascular Disease)
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-9500
IRINA KORABLEVA MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1500 JAMES SIMPSON JR WAY
COVINGTON, KY 41011
Kenton County (859) 655-8910

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 Aileen Heras-herzig's NPI number?

The NPI number for Aileen Heras-herzig is 1962545525. It was assigned to this individual provider in the NPPES registry on February 14, 2007. The provider is also known as Aileen Heras- Castro MD.

Where is Aileen Heras-herzig located?

Aileen Heras-herzig practices at 1500 James Simpson Jr Way Suite 301, Covington, KY 41011. The listed phone number is (859) 655-8910.

What is Aileen Heras-herzig's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Aileen Heras-herzig enrolled in Medicare?

Yes. Aileen Heras-herzig 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 Aileen Heras-herzig accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Aileen Heras-herzig 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 Aileen Heras-herzig affiliated with any hospitals?

According to CMS data, Aileen Heras-herzig is affiliated with St Elizabeth Dearborn Hospital, St Elizabeth Ft Thomas, St Elizabeth Edgewood, St Elizabeth Florence and St Elizabeth Grant.

When was this NPI record last updated?

The NPPES record for Aileen Heras-herzig was last updated on September 13, 2018. 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.