Individual provider Active NPI

Roger Harvey Heilman, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1417045709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G16660 Issued in CA
Practice address
550 S Vermont Ave
704B
Los Angeles, CA 90020-1912
Phone
(213) 739-7309
Fax
(213) 351-2024
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G16660 CA Primary

Addresses

Primary practice location

550 S Vermont Ave
704B
Los Angeles, CA 90020-1912

Mailing address

3535 Lombardy Rd
Pasadena, CA 91107-5628
Phone (626) 793-2302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G16660CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417045709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 LOMBARDY RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911075628",
            "telephone_number": "626-793-2302",
            "fax_number": "626-304-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "address_2": "704B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912",
            "telephone_number": "213-739-7309",
            "fax_number": "213-351-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "ROGER",
        "middle_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G16660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.