Active NPI
Gregory Wade Heinicke, D.O.
- Internal Medicine Physician
- Sacramento, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OP61040693
- Practice address
- 2315 Stockton Blvd
Sacramento, CA 95817-2201 - Phone
- (916) 734-8230
- NPI assigned
- Mar 31, 2017
- Last updated
- Jul 20, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OP61040693 | WA | Primary |
Addresses
Primary practice location
2315 Stockton Blvd
Sacramento, CA 95817-2201
Mailing address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-8230
Other practice location 1
624 E Front Ave
Spokane, WA 99202-2139
Phone (509) 626-9900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
311 S L St
Tacoma, WA 98405-3720
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
910 W 5TH Ave
Suite 1001
Spokane, WA 99204-2976
Phone (509) 755-6760
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP61040693 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Amplehealth | Internal Medicine | Current | Accepting new patients |
| 1125 Sir Francis Drake Boulevard Operating Company, LLC | Current | Accepting new patients |
Locations
6620 Coyle Ave
Ste 202
Carmichael, CA 95608
Phone (916) 961-3434
3270 Arena Blvd
Ste 405
Sacramento, CA 95834
Phone (916) 418-4595
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Organizations & group practices 5
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.
-
dba Multicare Neurological Surgery
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Internal Medicine Physician
- Carmichael, CA
- NPI 1508899758
-
dba Kentfield Rehabilitation & Specialty Hospital
- Long Term Care Hospital
- Kentfield, CA
- NPI 1760424261
-
dba MultiCare Deaconess Retail Pharmacy
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Pediatrics Physician
- Tacoma, WA
- NPI 1427601467
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MultiCare Deaconess Hospital
- General Acute Care Hospital
- Spokane, WA
- NPI 1356528269
-
dba Tacoma General Allenmore
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
dba MultiCare Valley Hospital
- General Acute Care Hospital
- Spokane Valley, WA
- NPI 1538345251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1295267987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172201",
"telephone_number": "916-734-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172201",
"telephone_number": "916-734-8230"
}
],
"practiceLocations": [
{
"address_1": "624 E Front Ave",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992022139",
"country_code": "US",
"telephone_number": "509-626-9900",
"fax_number": "509-626-9920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEINICKE",
"first_name": "GREGORY",
"middle_name": "WADE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-31",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "OP61040693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.