Shanti Elizabeth Herzog, FNP in Tumwater, WA - Medicare Nurse Practitioner

Shanti Elizabeth Herzog, FNP is a medicare enrolled "Nurse Practitioner - Family" in Tumwater, Washington. Her current practice location is 6334 Littlerock Rd Sw, Tumwater, Washington. You can reach out to her office (for appointments etc.) via phone at (360) 704-7590.

Shanti Elizabeth Herzog is licensed to practice in Washington (license number AP60791095) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1770959025.

Contact Information

	Shanti Elizabeth Herzog, FNP
	6334 Littlerock Rd Sw, Tumwater, WA 98512-7332
	(360) 704-7590
	(360) 704-7591

Map and Direction

Provider's Profile

Full Name	Shanti Elizabeth Herzog
Gender	Female
Speciality	Nurse Practitioner - Family
Location	6334 Littlerock Rd Sw, Tumwater, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770959025
Provider Enumeration Date: 08/20/2015
Last Update Date: 12/11/2020

Medicare PECOS Information:

PECOS PAC ID: 0941519060
Enrollment ID: I20180213001421

Medical Identifiers

Medical identifiers for Shanti Elizabeth Herzog such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770959025	NPI	-	NPPES
22959	Medicaid	OR
096511	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	AP60791095 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shanti Elizabeth Herzog allows following entities to bill medicare on her behalf.

Entity Name	Sea-mar Community Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811051170 PECOS PAC ID: 7315831161 Enrollment ID: O20040211001210

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shanti Elizabeth Herzog is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shanti Elizabeth Herzog, FNP 2101 E Yesler Way, Ste 210, Seattle, WA 98122-5959 Ph: (503) 988-7468	Shanti Elizabeth Herzog, FNP 6334 Littlerock Rd Sw, Tumwater, WA 98512-7332 Ph: (360) 704-7590

Reviews and Comments

Nurse Practitioner Nurses in Tumwater, WA

Mr. Christopher Thomas Ramos, MS, PMHMP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2011 Mottman Rd Sw Bldg 34-216, Tumwater, WA 98512 Phone: 360-358-2853
Louise Kaplan, PHD, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 150 Dennis St Sw Ste A, Tumwater, WA 98501 Phone: 360-754-6367 Fax: 360-754-6429
Diana Wilcox, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 344 Cleveland Ave Se Ste H, Tumwater, WA 98501 Phone: 360-561-9906
Jennifer Lynn Venable, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6334 Littlerock Rd Sw Bldg 6, Tumwater, WA 98512 Phone: 360-704-7590 Fax: 360-704-7591
Mandie Rose Gardner, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7146 Country Village Dr Sw, Tumwater, WA 98512 Phone: 219-384-7104
Dr. Jessica Bruce Ahern, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 150 Dennis St Sw, Tumwater, WA 98501 Phone: 360-754-6367
Kimberly Ireland, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 150 Dennis St Sw, Tumwater, WA 98501 Phone: 360-754-6367 Fax: 360-754-6429

Shanti Elizabeth Herzog, FNP - Medicare Nurse Practitioner in Tumwater, WA