HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) – Surgical Physician Assistant, NPI 1932433190

HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) is a healthcare provider. based in Coos bay, Oregon. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. 7462373-1206 (UT). The NPI Number for HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) is 1932433190

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT)
NPI
1932433190
Phone
(541) 267-5151
Address
1900 WOODLAND DR
Enumeration Date
21 September 2009
Last Update Date
8 November 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2009 (17 years ago)
PAC ID
2062550387
Group Practice PAC ID
4981878402
Professional Enrollment ID
I20170407001260
Address ID
ID836426351ME520XXRDXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:16State licenses:2Digital endpointsOther names

2,876 PHYSICIAN ASSISTANT in OR

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Provider Addresses for HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT)

  • North Bend Medical Center, 1900, Woodland Drive, Coos Bay, Coos County, Oregon, 97420, United States

    COOS BAY, OR 974202045

    Phone: (541) 267-5151

    Fax: (541) 266-4501

    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 7 Open Payments records for all available years, with a total value of $249.

Total Amount is formed as General ($249) + Research ($0) + Ownership ($0) = $249.

Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Medtronic, Inc. ($187).

Total Amount

$249

General + Research + Ownership

Payments

7

Total payment records

General Amount

$249

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-26

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: 2017-04-07

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
I20170407001260IPhysician AssistantIDTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes2221$0
43775Partial removal of stomach for weight loss using an endoscope1515$0
43281Repair of hernia of muscle at esophagus and stomach using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 97420)

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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: 4981878402View full group profile
NameSpecialtyState
Family PracticeME
Internal MedicineID
Family PracticeID
-TX
-OR
Hand SurgeryID
-ID
Nurse PractitionerID
Physician AssistantID
General SurgeryID

Reviews

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Frequently asked questions

Where can patients find HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT)'s NPI?
You can confirm HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) with NPI 1932433190; it appears in the national provider directory.
Is HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) currently active in the NPI registry?
CMS-published data lists HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) as an active registrant.
Can you summarize HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT)'s specialty in plain language?
Clinically, the directory lists HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) with Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) practice in Oregon?
You will see Coos Bay, Oregon on file for HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT) alongside any extra practice locations.
How can I contact HAZEN TIMOTHY HERZOG (PHYSICIAN ASSISTANT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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