Richard D Herzog (NPI# 1770667180, PAC ID# 8224072855) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1770667180 |
| PAC ID by PECOS | 8224072855 |
| Professional Enrollment ID | I20060323000174 |
| Full Name | Richard D Herzog |
| Organization Legal Name | SQUARE CARE MEDICAL GROUP LLP |
| Address |
3629 Bell Blvd Bayside NY 11361-2056 |
| Phone Number | 7182245800 |
| Gender | M |
| Credential | MD |
| Medical School | CREIGHTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1975 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 7012938434 |
| Number of Group Practice Members | 67 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330106 | NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET |
| Address | Phone | Organization |
|---|---|---|
| 3629 Bell Blvd, Bayside, NY 11361-2056 | 7182245800 | SQUARE CARE MEDICAL GROUP LLP |
| Organization Legal Name | SQUARE CARE MEDICAL GROUP LLP |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Patricia Paccione | Nurse Practitioner | Square Care Medical Group LLP | 200 W Main St, Suite A103, Babylon, NY 11702-3434 |
| Ella Uvadyeva | Obstetrics/gynecology | Square Care Medical Group LLP | 173 Mineola Blvd, Suite 200, Mineola, NY 11501-2530 |
| Terah J Stiell | Physician Assistant | Square Care Medical Group LLP | 40 Crossways Park Dr, Suite 101, Woodbury, NY 11797-2038 |
| Christopher J Berard | Family Medicine | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Stacey Joy Digiacomo | Physician Assistant | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Jennifer Slagus | Obstetrics/gynecology | Square Care Medical Group LLP | 48 Route 25a, Suite 207, Smithtown, NY 11787-1448 |
| Charles T Mann | Obstetrics/gynecology | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Laura J Cerlini | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Loren Lyons | Nurse Practitioner | Square Care Medical Group LLP | 191 Herricks Rd, Garden City Park, NY 11040-5236 |
| Krista Wasserman | Obstetrics/gynecology | Square Care Medical Group LLP | 1615 Northern Blvd, Suite 106, Manhasset, NY 11030-3033 |
| Street Address |
3629 BELL BLVD |
| City | BAYSIDE |
| State | NY |
| Zip | 11361-2056 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dolis Estevez | Physical Therapy | Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | 3629 Bell Blvd, Lowr Level, Bayside, NY 11361-2056 |
| Ilia E Calluzzo | Obstetrics/gynecology | Square Care Medical Group LLP | 3629 Bell Blvd, Bayside, NY 11361-2056 |
| Gilad A Greenberg | Obstetrics/gynecology | Square Care Medical Group LLP | 3629 Bell Blvd, Bayside, NY 11361-2056 |
| Randi M Rothstein | Obstetrics/gynecology | Square Care Medical Group LLP | 3629 Bell Blvd, Bayside, NY 11361-2056 |
| Diana M Saporito | Physical Therapy | Sports Physical Therapy Occupational Therapy and Rehabilitation Servic | 3629 Bell Blvd, Lowr Level, Bayside, NY 11361-2056 |
| Christine Melgar | Obstetrics/gynecology | Square Care Medical Group LLP | 3629 Bell Blvd, Bayside, NY 11361-2056 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ketan D Vora | Physical Medicine and Rehabilitation | Ketan D Vora Do PC | 213 -15 Bell Boulevard, Bayside, NY 11361 |
| Alireza Shirvani | Internal Medicine | 3501 202nd St, Bayside, NY 11361-1117 | |
| William M Duke Jr. | Internal Medicine | 3501 202nd St, Bayside, NY 11361-1117 | |
| Inna Janas | Internal Medicine | Nandi Janas Medical, P.C. | 3501 202nd St, Bayside, NY 11361-1117 |
| Andrew L Isopo | Internal Medicine | Ny Priority Medical Care Pllc | 3501 202nd St, Bayside, NY 11361-1117 |
| Mariangela Penna | Chiropractic | 20919 34th Rd, Bayside, NY 11361-1424 | |
| Jia Park | Family Medicine | 210 - 08, Bayside, NY 11361-1431 | |
| Kyung H Yoo | Physical Therapy | 21315 33rd Rd, Bayside, NY 11361-1508 | |
| Ravi Loona | Orthopedic Surgery | 21135 34th Rd, Bayside, NY 11361-1512 | |
| Michael Baron | Oral Surgery | 34 -43, Bayside, NY 11361-1554 | |
| Find all physicians in zip 11361 | |||
| City | BAYSIDE |
| Zip Code | 11361 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | BAYSIDE + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.