NPIMap

Individual provider Active NPI

Kari Case Heistand, M.D.

  • Psychiatry Physician
  • Port Townsend, WA
National Provider Identifier
1043301930
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00045509 Issued in WA
Practice address
210 Polk St Ste 4a
Port Townsend, WA 98368-6739
Phone
(360) 385-9918
Fax
(360) 385-1496
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00045509 WA Primary

Addresses

Primary practice location

210 Polk St Ste 4a
Port Townsend, WA 98368-6739

Mailing address

96 Twinsview CT
Port Ludlow, WA 98365-9219
Phone (360) 621-9475

Other identifiers 1

IdentifierTypeStateIssuer
1871714857MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000109 WA Practitioner - Psychiatry 5698775898 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Washington School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Jefferson County Public Hospital District No 2Group PAC ID 4789593708, 151 clinicians

Practice addresses (Care Compare)

1303 Washington St
Port Townsend, WA 98368-6715
Phone (360) 385-9818

915 Sheridan St
Port Townsend, WA 98368-2931
Phone (360) 379-8031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles (4 of 6)

OrganizationSpecialtyStatusNew patients
Port Townsend Psychiatric Medicine CurrentSince May 3, 2018 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Aug 24, 2018 Accepting new patients
Department of Social Past Accepting new patients
Jefferson County Public Hospital District No 2 Past Accepting new patients

Locations

1303 Washington St
Port Townsend, WA 98368
Phone (360) 385-3100

210 Polk St
Ste 4A
Port Townsend, WA 98368
Phone (360) 385-9818

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

1136 Water St
Ste 106
Port Townsend, WA 98368
Phone (360) 379-8779

915 Sheridan St
Port Townsend, WA 98368
Phone (360) 379-8031

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: kheistand925430@wm.providencedirect.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1043301930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 TWINSVIEW CT",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659219",
            "telephone_number": "360-621-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 POLK ST STE 4A",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686739",
            "telephone_number": "360-385-9918",
            "fax_number": "360-385-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISTAND",
        "first_name": "KARI",
        "middle_name": "CASE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00045509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871714857",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.