Thiebaut Thomas Herzog, - Medicare Pediatrics in Bend, OR

Thiebaut Thomas Herzog, is a medicare enrolled "Pediatrics" physician in Bend, Oregon. His current practice location is 2500 Ne Neff Rd, Bend, Oregon. You can reach out to his office (for appointments etc.) via phone at (541) 382-4321.

Thiebaut Thomas Herzog is licensed to practice in Washington (license number 1114344058) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114344058.

Contact Information

Thiebaut Thomas Herzog,
2500 Ne Neff Rd,
Bend, OR 97701-6015
(541) 382-4321
Not Available



Physician's Profile

Full NameThiebaut Thomas Herzog
GenderMale
SpecialityPediatrics
Location2500 Ne Neff Rd, Bend, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114344058
  • Provider Enumeration Date: 03/27/2014
  • Last Update Date: 11/03/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7618288812
  • Enrollment ID: I20220818002062

Medical Identifiers

Medical identifiers for Thiebaut Thomas Herzog such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114344058NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 1114344058 (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. Thiebaut Thomas Herzog allows following entities to bill medicare on his behalf.
Entity NameSt Charles Health System Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982621447
PECOS PAC ID: 3870402852
Enrollment ID: O20040112000045

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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. Thiebaut Thomas 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 AddressPractice Location Address
Thiebaut Thomas Herzog,
2801 N Gantenbein Ave,
Portland, OR 97227-1623

Ph: (503) 276-6500
Thiebaut Thomas Herzog,
2500 Ne Neff Rd,
Bend, OR 97701-6015

Ph: (541) 382-4321

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Pediatrics Doctors in Bend, OR

Benjamin Bruno Barsotti, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2500 Ne Neff Rd, Bend, OR 97701
Phone: 541-706-6892    Fax: 541-706-6813
Dr. Brenna Kathryn Lewis, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2500 Ne Neff Rd, Bend, OR 97701
Phone: 541-706-6892    Fax: 541-706-6813
Mr. Stacy C. Berube, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 2200 Ne Professional Ct, Bend, OR 97701
Phone: 541-389-6313    Fax: 541-389-8760
Dr. Kristi A Nix, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2084 Ne Professional Ct, Bend, OR 97701
Phone: 541-383-3005    Fax: 541-383-1883
Scott Chambers Olson, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2500 Ne Neff Rd, Bend, OR 97701
Phone: 541-382-4321    
Erika Stephanie Beard-irvine, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 403 Ne Revere Ave, Bend, OR 97701
Phone: 541-241-6371    Fax: 877-991-7408
Dr. Michelle R Mills, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 815 Sw Bond St, Bend, OR 97702
Phone: 541-382-4900    

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