Individual provider Active NPI

Stephanie Karalis Heninger, PA-C

  • Physician Assistant
  • Oakland, CA
National Provider Identifier
1306322045
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55712 Issued in CA
Practice address
1411 E 31St St
Oakland, CA 94602-1092
Phone
(510) 437-4430
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55712 CA Primary

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1092

Mailing address

1411 E 31St St
Oakland, CA 94602-1092
Phone (510) 437-4430

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907002352 CA Practitioner - Physician Assistant 8426308651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

6955 Foothill Blvd
Suite 200
Oakland, CA 94605-2426
Phone (510) 567-5704

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55712CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jul 27, 2020 Accepting new patients
Alameda Health System CurrentSince Jul 27, 2020 Accepting new patients
Webster Orthopaedic Medical Group, a Professional Corporation CurrentSince Jul 30, 2018 Accepting new patients
Alameda Health System Past Accepting new patients

Locations

4000 Dublin Blvd
Ste 100
Dublin, CA 94568
Phone (800) 943-8099

1133 E Stanley Blvd
Ste 111
Livermore, CA 94550
Phone (925) 371-5377

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

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

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

200 Porter Dr
Ste 101
San Ramon, CA 94583
Phone (925) 838-1440

Interoperability endpoints

  • Direct secure messaging: sthompson58938@alamedahs.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1306322045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENINGER",
        "first_name": "STEPHANIE",
        "middle_name": "KARALIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.