Benjamin James Heredia, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5922 Issued in OR

Practice address

524 SE 14TH Ave
Portland, OR 97214-2428

Phone

(971) 544-7058

NPI assigned

Jun 10, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pivot Health IncGroup PAC ID 3870984875, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pivot Health Inc

  • Chiropractor
  • Oregon City, OR
  • NPI 1942666185
  Medicare reassignment Care Compare group NPD
• Premier Care Chiropractic, LLC

  • Chiropractor
  • Portland, OR
  • NPI 1710507348
  NPD
• Premier Care Wellness Company

  • Chiropractor
  • Portland, OR
  • NPI 1053012583
  NPD
• Pivot Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1346169851
  NPD (past)

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1356790281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142428",
            "telephone_number": "971-544-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142428",
            "telephone_number": "971-544-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "BENJAMIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33582",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacy L Herbst, PMHNP-BC
• Rachel Herbst, DC
• Kimberly J Herder, MD
• Here and Now Counseling
• Here to Feel, LLC
• Melissa Hereford
• Chelsea Elaine Hereth, LMT
• Jennifer Leigh Herget
• Randi Rebecca Heriford
• Kendra G Herigstad

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.