Individual provider Active NPI

Agiua Heath, M.D.

  • Internal Medicine Physician
  • Stanford, CA
National Provider Identifier
1174747570
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G058616 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G058616 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140905002554 CA Practitioner - Internal Medicine 5698951044 Reassigns benefits to 1 organization
I20170224000147 DC Practitioner - Internal Medicine 5698951044 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58616CAMDPharmacist
G058616CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jun 30, 2014 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC Internal Medicine CurrentSince May 26, 2017 Accepting new patients
Privia Medical Group, LLC CurrentSince May 26, 2017 Accepting new patients
Alameda Health System CurrentSince Jun 30, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

1201 Seven Locks Rd
Ste 111
Rockville, MD 20854
Phone (301) 762-5020

Organizations & group practices 7

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1174747570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "AGIUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G058616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.