Keith Gregory Heinzerling, MD

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

A79201 Issued in CA

Practice address

1301 20TH St Ste 540
Santa Monica, CA 90404-2118

Phone

(310) 582-7612

Fax

(424) 277-6342

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Addiction MedicineAlso: Internal Medicine

Education

Stanford University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kheinzerling1074529@oc.providencedirect.org

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.

• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Psychedelic Medical Associates PC

  • Addiction Medicine (Internal Medicine) Physician
  • Santa Monica, CA
  • NPI 1588341689
  NPD Authorized official
• Providence Saint Johns Medical Foundation

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1518438712

  Internal Medicine

  NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1184724932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 COLORADO AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043414",
            "telephone_number": "310-319-4700",
            "fax_number": "310-393-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 540",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042118",
            "telephone_number": "310-582-7612",
            "fax_number": "424-277-6342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904043414",
            "country_code": "US",
            "telephone_number": "310-319-4700",
            "fax_number": "310-393-5659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZERLING",
        "first_name": "KEITH",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A79201",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A79201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kheinzerling1074529@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1301 20th St Ste 540",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kheinzerling1074529@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2125 Arizona Ave",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904041337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Taylor Leighan Heflin
• Donna Lee Heider, MFT, ATR
• Brenda Heidrich, PHD
• Rebekah Heimann
• Holly C. Hein, PH.D.
• Jeena Kaur Heir, MD
• Bruce Allan Heller, PH.D.
• Jacqueline Heller, M.D.
• Jerome Paul Helman, MD
• Helpful Home Health,Inc

• Addiction Medicine (Internal Medicine) Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.