EDWARD EVERETT HEROLD (MD) – Anesthesiology Physician, NPI 1154371177

EDWARD EVERETT HEROLD (MD) is a healthcare provider. based in San jose, California. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. G79072 (CA). The NPI Number for EDWARD EVERETT HEROLD (MD) is 1154371177

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
EDWARD EVERETT HEROLD (MD)
NPI
1154371177
Phone
(503) 372-2740
Address
PO BOX 49168
Enumeration Date
11 May 2006
Last Update Date
7 April 2011

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Secondary Phone
8317244741
Graduation Year
1992 (34 years ago)
PAC ID
2365523297
Group Practice PAC ID
0749688000
Professional Enrollment ID
I20080117000280
Address ID
CA950762468WA75XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

6,391 ANESTHESIOLOGY in CA

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Provider Addresses for EDWARD EVERETT HEROLD (MD)

  • Wyndham San José Herradura, Vía 1, Real Cariari, Ulloa, Heredia, Heredia Province, 40104, Costa Rica

    SAN JOSE, CA 951619168

    Phone: (503) 372-2740

    Fax: (503) 372-2754

    Type: Mailing

  • Dominican Hospital, 1555, Soquel Drive, Live Oak, Santa Cruz County, California, 95065, United States

    SANTA CRUZ, CA 950651705

    Phone: (831) 462-7700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-01-17

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080117000280IAnesthesiologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95161)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749688000View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)NV
Certified Registered Nurse Anesthetist (Crna)NC
Certified Registered Nurse Anesthetist (Crna)NY
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)AZ
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What is the 10-digit NPI for EDWARD EVERETT HEROLD (MD)?
EDWARD EVERETT HEROLD (MD) — NPI 1154371177 — is the standard way to identify this listing.
Can I rely on EDWARD EVERETT HEROLD (MD) being an active provider?
As of the registry snapshot, EDWARD EVERETT HEROLD (MD) is marked active.
What healthcare role does EDWARD EVERETT HEROLD (MD) hold?
Scheduling teams often label EDWARD EVERETT HEROLD (MD) under Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What area does EDWARD EVERETT HEROLD (MD) serve?
EDWARD EVERETT HEROLD (MD)'s listing highlights San Jose, California; more addresses can appear in NPPES.
Why does EDWARD EVERETT HEROLD (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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