Individual provider Active NPI

Andrew Neiheisel, M.D.

  • Pediatric Anesthesiology Physician
  • Loma Linda, CA
National Provider Identifier
1114189396
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
A120062 Issued in CA
Practice address
11234 Anderson St
MC-2532-D
Loma Linda, CA 92354-2804
Phone
(909) 558-8054
Fax
(909) 558-0187
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X A120062 CA Primary

Addresses

Primary practice location

11234 Anderson St
MC-2532-D
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Dept of Anesthesiology
Loma Linda, CA 92354-2804

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130810000000 CA Practitioner - Anesthesiology 1658513239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Anesthesia Associates Medical Group IncGroup PAC ID 4688642028, 20 clinicians

Practice addresses (Care Compare)

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 537-1234

Hospital & facility affiliations

  • Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120062CAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Anesthesia Associates Medical Group, Inc CurrentSince Jan 14, 2014 Accepting new patients
Loma Linda Univ Anesthesiology Medical Group Inc Past Accepting new patients

Locations

20103 Lake Chabot Rd
Hayward, CA 94546
Phone (510) 537-1234

Interoperability endpoints

  • Direct secure messaging: aneiheisel194419@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1114189396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "DEPT OF ANESTHESIOLOGY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "MC-2532-D",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8054",
            "fax_number": "909-558-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIHEISEL",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "A120062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.