Individual provider Active NPI

Heather R Macdonald, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1326158619
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A75177 Issued in CA
Practice address
1510 San Pablo St
Suite 514
Los Angeles, CA 90033-5324
Phone
(323) 865-3000
Fax
(323) 442-6798
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A75177 CA Primary

Addresses

Primary practice location

1510 San Pablo St
Suite 514
Los Angeles, CA 90033-5324

Mailing address

1510 San Pablo St
Suite 514
Los Angeles, CA 90033-5324
Phone (323) 865-3000

Other identifiers 3

IdentifierTypeStateIssuer
00A751770OtherCABLUE SHIELD PIN
00A751770C29OtherCACAL OPTIMA
00A751770MedicaidCA

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
I20061101000337 CA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 0042217267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16305 Sand Canyon Ave
Suite 160
Irvine, CA 92618-3790
Phone (949) 557-0186

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy25
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75177CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Obstetrics & Gynecology CurrentSince Sep 1, 2006 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2006 Accepting new patients
Usc Surgeons, Inc. Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Riverside Medical Group PC Past Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1510 San Pablo St
Ste 514
Los Angeles, CA 90033
Phone (323) 442-5910

1441 Eastlake Ave
Ste 7419
Los Angeles, CA 90089

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1326158619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SAN PABLO ST",
            "address_2": "SUITE 514",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335324",
            "telephone_number": "323-865-3000",
            "fax_number": "323-442-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SAN PABLO ST",
            "address_2": "SUITE 514",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335324",
            "telephone_number": "323-865-3000",
            "fax_number": "323-442-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "HEATHER",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A75177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "00A751770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL OPTIMA",
            "identifier": "00A751770C29",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A751770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.