Individual provider Active NPI

Robert Scott Heidersbach, MD

  • Pediatric Critical Care Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1275547473
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
G83682 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 498-7103
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X G83682 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

2680 Hanover St
Palo Alto, CA 94304-1117

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
I20060824000585 CA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 5597768960 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83682CAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates Pediatric Critical Care Medicine CurrentSince Sep 1, 2019 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 1, 2019 Accepting new patients
University of California San Francisco CurrentSince Sep 1, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 1, 2019 Accepting new patients
University of California San Francisco CurrentSince Sep 1, 2019 Accepting new patients
University of California San Francisco Past Accepting new patients
Regents of the University of California Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

300 Pasteur Dr
#5500
Stanford, CA 94305
Phone (415) 723-5525

Interoperability endpoints

  • Direct secure messaging: rheidersbach120790@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1275547473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 HANOVER ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-498-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDERSBACH",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "G83682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.