JEFFERY KOLK HERBERT (P.A.) – Surgical Physician Assistant, NPI 1174604359

JEFFERY KOLK HERBERT (P.A.) is a healthcare provider. based in Medford, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. PA00572 (OR). The NPI Number for JEFFERY KOLK HERBERT (P.A.) is 1174604359

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
JEFFERY KOLK HERBERT (P.A.)
NPI
1174604359
Phone
(541) 282-6685
Address
520 MEDICAL CENTER DR
Enumeration Date
17 October 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
5419308907
Graduation Year
1997 (29 years ago)
PAC ID
4789587049
Group Practice PAC ID
4789589540
Professional Enrollment ID
I20040202000773
Address ID
OR975044316ME520XXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

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Provider Addresses for JEFFERY KOLK HERBERT (P.A.)

  • 520, Medical Center Drive, Medford, Jackson County, Oregon, 97504, United States

    SUITE 300

    MEDFORD, OR 975044334

    Phone: (541) 282-6685

    Fax: (541) 282-6686

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($27).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-02-02

PECOS data refreshed: 2026-05-27

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
I20040202000773IPhysician AssistantORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
47563Removal of gallbladder with x-ray study of bile ducts using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 97504)

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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: 4789589540View full group profile
NameSpecialtyState
Physician AssistantOR
General SurgeryTX
General Surgery, Vascular SurgeryOR
Vascular Surgery, General SurgeryOR
Physician AssistantOR
Physician AssistantOR
-OR
General Surgery, Vascular SurgeryOR
-OR
Vascular Surgery, General SurgeryOR

Reviews

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Frequently asked questions

What is the standard ID for JEFFERY KOLK HERBERT (P.A.) in the U.S.?
In the U.S., JEFFERY KOLK HERBERT (P.A.) is identified by NPI 1174604359.
Should I treat JEFFERY KOLK HERBERT (P.A.) as an active provider?
Patients and plans typically see JEFFERY KOLK HERBERT (P.A.) as active in the national extract.
What services align with JEFFERY KOLK HERBERT (P.A.)'s listing?
JEFFERY KOLK HERBERT (P.A.)'s public classification highlights Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to JEFFERY KOLK HERBERT (P.A.)?
JEFFERY KOLK HERBERT (P.A.) shows a connection to Medford, Oregon in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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