MR. BRUCE EDWARD HERTZENBERG (NPI# 1588646970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588646970 |
| Entity Type | Individual |
| Full Name | MR. BRUCE EDWARD HERTZENBERG |
| Credential | LICENSED SURG ASSIST |
| Practice Address |
5130 Holly Ln N #3 Plymouth MN 55446-1772 |
| Practice Telephone | 7636949248 |
| Practice Fax Number | 7636940293 |
| Mailing Telephone | 7636949248 |
| Mailing Fax Number | 7636940293 |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
SA00271 | TX | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | CERT. FIRST ASSISTANT | 89003 | 01 |
| TX | LIC. SURGICAL ASSISTANT | SA00271 | 01 |
| MN | CERT. SURGICAL TECHNICIAN | 066759 | 01 |
| Street Address |
5130 HOLLY LN N #3 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55446-1772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114552379 | Molly M Mahoney | Pharmacist | 4110 Juneau Lane N, Plymouth, MN 55446 | 2020-03-09 |
| 1073064804 | Owen Payne Kusick | Student in an Organized Health Care Education/Training Program | 16717 49th Pl N, Plymouth, MN 55446 | 2016-10-17 |
| 1043696214 | Kari Shoemaker | Speech-Language Pathologist | 5855 Cheshire Parkway, Plymouth, MN 55446 | 2015-08-10 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1851715163 | Group Health Plan Inc | Clinic/Center | 5000 Fernbrook Ln N, Plymouth, MN 55446 | 2014-02-06 |
| 1588903009 | Laura Davidson | Physician Assistant | 3365 Plymouth Blvd., Suite 110, Plymouth, MN 55446 | 2013-02-04 |
| 1366680688 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6025 Shenandoah Ln N, Plymouth, MN 55446 | 2009-01-23 |
| 1205046646 | Merida A Miller | Obstetrics & Gynecology | 4155 Cty Rd 101 N, Plymouth, MN 55446 | 2007-05-23 |
| 1376684746 | West Metro Ophthalmology, Pa | Ophthalmology | 15655 37th Ave N Ste 200, Plymouth, MN 55446 | 2007-02-09 |
| 1952401390 | Grand St Paul Cvs LLC | Pharmacy | 4140 Rd 101 N, Plymouth, MN 55446 | 2006-09-25 |
| Find all providers in zip 55446 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699882548 | Metro First Assistants, Inc. | Specialist/Technologist, Other | 5130 Holly Ln N Unit 3, Plymouth, MN 55446-1773 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700117207 | Kristi Laine Kornder | Specialist/Technologist, Other | 1601 St Francis Ave, Shakopee, MN 55379 | 2010-01-22 |
| 1518019389 | Kathleen Gail Rajek | Specialist/Technologist, Other | 6405 France Ave S Ste W400, Edina, MN 55435-2192 | 2007-01-18 |
| 1578580643 | Lu Ann Runkle | Specialist/Technologist, Other | 6465 Wayzata Blvd, Ste 315, St Louis Park, MN 55426-1728 | 2006-07-16 |
| 1376529149 | Benjamin N Quintero | Specialist/Technologist, Other | 4305 Dunrovin Ln, Eagan, MN 55123-1760 | 2005-12-22 |
| 1902396799 | Kristi Ann Gingras | Specialist/Technologist, Other | 1701 Curve Crest Blvd W Ste 104, Stillwater, MN 55082-6181 | 2018-05-16 |
| 1164852554 | Sara Mary Fatland | Specialist/Technologist, Other | 4010 W 65th St, Edina, MN 55435-1706 | 2013-11-21 |
| 1386086502 | Roberta Amber Bolitho | Specialist/Technologist, Other | 1000 W 140th St, Suite 201, Burnsville, MN 55337-4480 | 2013-07-30 |
| 1063656452 | Crystal Ann Malm | Specialist/Technologist, Other | 6545 France Ave S, Suite 160, Edina, MN 55435-2131 | 2009-04-29 |
| 1538311105 | Diane Carol Kaus | Specialist/Technologist, Other | 7373 France Ave S, Suite 312, Edina, MN 55435-4534 | 2008-10-15 |
| 1033384813 | Nicole Marie Yohn | Specialist/Technologist, Other | 6465 Wayzata Blvd, Suite 900, St Louis Park, MN 55426-1728 | 2008-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.