Active NPI
Veronica Heredia, MD
- Pediatrics Physician
- San Jose, CA
National Provider Identifier
1457538860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A73219
- Practice address
- 2016 Forest Ave
Suite # 7
San Jose, CA 95128-4804 - Phone
- (408) 289-8410
- Fax
- (408) 289-8507
- NPI assigned
- Jan 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A73219 | CA | Primary |
Addresses
Primary practice location
2016 Forest Ave
Suite # 7
San Jose, CA 95128-4804
Mailing address
2016 Forest Ave
Suite # 7
San Jose, CA 95128-4804
Phone (408) 289-8410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A732190 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| A73219 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Santa Clara | Past | Accepting new patients | |
| Veronica Heredia, MD, a Medical Corporation | Pediatrics | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- vheredia125715@santaclaravalley.direct-ci.net
Organizations & group practices 2
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.
-
- Pediatrics Physician
- San Jose, CA
- NPI 1093773079
-
- General Acute Care Hospital
- San Jose, CA
- NPI 1063406551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244073600000",
"number": "1457538860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2016 FOREST AVE",
"address_2": "SUITE # 7",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951284804",
"telephone_number": "408-289-8410",
"fax_number": "408-289-8507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 FOREST AVE",
"address_2": "SUITE # 7",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951284804",
"telephone_number": "408-289-8410",
"fax_number": "408-289-8507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREDIA",
"first_name": "VERONICA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-28",
"last_updated": "2009-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A73219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A732190",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.