Individual provider Active NPI

Heather Maloney, PA-C

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1083923882
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15621 Issued in CA
Practice address
44274 George Cushman CT Ste 208
Temecula, CA 92592-5945
Phone
(951) 501-4252
NPI assigned
Sep 28, 2010
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15621 CA Primary

Addresses

Primary practice location

44274 George Cushman CT Ste 208
Temecula, CA 92592-5945

Mailing address

41327 Cresta Verde CT
Temecula, CA 92592-4403
Phone (951) 695-0740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220429001390 CA Practitioner - Physician Assistant 3678644655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Integrative Medical Specialists IncGroup PAC ID 0446629562, 4 clinicians

Practice addresses (Care Compare)

44274 George Cushman CT
Suite 208
Temecula, CA 92592-5945
Phone (951) 501-4252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15621CAMDAcupuncturist
PA15621CAMDPhysician Assistant

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1083923882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41327 CRESTA VERDE CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924403",
            "telephone_number": "951-695-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44274 GEORGE CUSHMAN CT STE 208",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925945",
            "telephone_number": "951-501-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.