Caroline Emma Heidbreder, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60587067 Issued in WA

Practice address

5005 Main St
Suite 125
Tacoma, WA 98407-3168

Phone

(253) 759-4522

Fax

(253) 759-4699

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMN IndustriesGroup PAC ID 0143583807, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• CMN Industries

  • Plastic Surgery Physician
  • Olympia, WA
  • NPI 1144725649
  Medicare reassignment Care Compare group
• Olympic Dermatology and Laser Clinic P S

  • Dermatology Physician
  • Olympia, WA
  • NPI 1467470914
  Medicare reassignment
• Pearl Plastic Surgery, PLLC

  • Multi-Specialty Clinic/Center
  • Olympia, WA
  • NPI 1063245249
  NPD
• Pearl Plastic Surgery, PLLC

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1508573221
  NPD

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1487020830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 34TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262615",
            "telephone_number": "773-322-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 MAIN ST",
            "address_2": "SUITE 125",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984073168",
            "telephone_number": "253-759-4522",
            "fax_number": "253-759-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDBREDER",
        "first_name": "CAROLINE",
        "middle_name": "EMMA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60587067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Francis Hefner, APRN,CNP
• Nancy Hegdahl
• Rebecca Leann Brock Hegewald
• Sara Elizabeth Heiberg, CPO
• Paige Heid
• Brooke Gresham Heide, LMP
• Heidi Jones LLC
• Thomas Lawrence Heidinger
• Michael E Heil, O.D.
• Henry Castle Heim, DDS

• Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.