Jeanne Marie Herzog, PHD
NPI 1124173133ActiveIndividual· Psychologist· Elm Grove, WI
Opted out of Medicare from May 2013 to May 2027. Psychologist (PHD) in Elm Grove, Wisconsin, licensed in WI, with an NPI issued in January 2007.
Overview
| NPI | 1124173133 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Jan 23, 2007 |
| Last updated in NPPES | Mar 15, 2023 |
| Certified by provider | Mar 15, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 2176057 | WI |
| Psychologist, Clinical | 103TC0700X | 2176-57 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out May 1, 2013 – May 1, 2027 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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