Individual provider Active NPI

Gregory Wade Heinicke, D.O.

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1295267987
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP61040693 Issued in WA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-8230
NPI assigned
Mar 31, 2017
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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 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, CA2 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
I20200507000315 WA Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5294166203 Reassigns benefits to 1 organization
I20240418002473 CA Practitioner - Internal Medicine 5294166203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

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

LicenseStateTypeSpecialty
OP61040693WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 6, 2025 Accepting new patients
Multicare Health System CurrentSince Aug 6, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Amplehealth Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
1125 Sir Francis Drake Boulevard Operating Company, LLC CurrentSince Mar 1, 2024 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.