Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114344058 Individual Practitioner Male Practitioner

Thiebaut Thomas Herzog

Pediatrics • Bend, OR

Professional Overview & Biography Verified Profile Summary

Thiebaut Herzog is a registered healthcare professional specializing in Pediatrics in Bend, OR. Practice services are available at 2500 NE NEFF RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2500 Ne Neff Rd

Bend, OR 977016015

Telephone 5413824321
Associated Practice Facility / Clinic
🏢 Bend Anesthesiology Group, Pc Facility NPI 1467400200

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Bend, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.9 Yrs
Regional Practice Density
50 Specialists

Practicing in Bend, OR (880 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-04-06
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA 1114344058

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

4800 Sand Point Way Ne # Oc.7830

Seattle, WA 981053901

Phone: 2069872525

2801 N Gantenbein Ave

Portland, OR 972271623

Phone: 5032766500

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Jaqueline Campagna , PT

Physical Therapist

NPI 1003230434

Physical Therapist

Samantha Mullis , NNP

Nurse Practitioner - Neonatal, Critical Care

NPI 1003468844
NPI 1023065257

Doctor of Medicine (M.D.)

Karen Gnass , RDLD

Dietitian, Registered

NPI 1023228046
Dr. Suzanne Hiramatsu , MD

Emergency Medicine

NPI 1023310919

Doctor of Medicine (M.D.)

Mitchell Davis , PA

Physician Assistant

NPI 1023721883

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location November 03, 2022

Registered at 2500 NE NEFF RD, BEND, OR 977016015 (Tel: 5413824321)

📍
Updated Business Mailing Address November 03, 2022

Registered at 2801 N GANTENBEIN AVE, PORTLAND, OR 972271623 (Tel: 5032766500)

NPI Profile Active July 26, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location July 26, 2014

Registered at 4800 SAND POINT WAY NE # OC.7830, SEATTLE, WA 981053901 (Tel: 2069872525)

📍
Updated Business Mailing Address July 26, 2014

Registered at 4800 SAND POINT WAY NE # OC.7830, SEATTLE, WA 981053901

👤
Provider Name / Credentials Updated July 26, 2014

Recorded as THIEBAUT HERZOG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2014

Pediatrics (License #1114344058 in WA)

🟢
Initial NPI Registration & Enumeration March 27, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114344058
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2014
Last Update: November 03, 2022
Sole Proprietor: No

Mailing Address

2801 N Gantenbein Ave

Portland, OR 972271623

Phone: 5032766500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.