NPIMap

Individual provider Active NPI

Heather Poupore-King, PHD

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Redwood City, CA
National Provider Identifier
1326274176
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
PSY23112 Issued in CA
Practice address
450 Broadway St
Pavillion a, 1St Floor
Redwood City, CA 94063-3132
Phone
(650) 723-6238
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X PSY23112 CA Primary

Addresses

Primary practice location

450 Broadway St
Pavillion a, 1St Floor
Redwood City, CA 94063-3132

Mailing address

300 Pasteur Dr
Palo Alto, CA 94305-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121005000642 CA Practitioner - Clinical Psychologist 3971752924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

420 Broadway St
Redwood City, CA 94063-3132
Phone (650) 723-4000

450 Broadway St
Redwood City, CA 94063-3132
Phone (650) 723-4000

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY23112CAMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Aug 6, 2012 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Aug 6, 2012 Accepting new patients
LPCH Medical Group Div of Lucile Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients

Locations

450 Broadway St
Fl 1
Redwood City, CA 94063
Phone (650) 723-6238

450 Broadway St
Redwood City, CA 94063
Phone (650) 723-5643

450 Broadway St
Fl 2
Redwood City, CA 94063
Phone (650) 498-3931

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 6

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 7

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1326274176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST",
            "address_2": "PAVILLION A, 1ST FLOOR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-723-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUPORE-KING",
        "first_name": "HEATHER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "PSY23112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.