Individual provider Active NPI

Michael Alan Heisman, D.P.M.

  • Podiatrist
  • San Jose, CA
National Provider Identifier
1598760373
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E02316 Issued in CA
Practice address
175 N Jackson Ave Ste 200
San Jose, CA 95116-1909
Phone
(408) 384-7160
NPI assigned
Jun 17, 2005
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E02316 CA Primary

Addresses

Primary practice location

175 N Jackson Ave Ste 200
San Jose, CA 95116-1909

Mailing address

175 N Jackson Ave Ste 200
San Jose, CA 95116-1909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000483 CA Practitioner - Podiatry 8628096591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

15899 Los Gatos Almaden Rd
Suite 12
Los Gatos, CA 95032-3739
Phone (408) 358-2663

175 N Jackson Ave
Suite 200
San Jose, CA 95116-1909
Phone (408) 384-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2316CAMDCounselor
E02316CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Mar 1, 2021 Accepting new patients
Bass Medical Group CurrentSince Jan 15, 2024 Accepting new patients
Bass Medical Group Podiatrist Current Accepting new patients
Caremore Health Plan CurrentSince Sep 1, 2019 Accepting new patients
Bass Medical Group CurrentSince Jan 15, 2024 Accepting new patients
Richard J Trevino MD a Professional Corporation PastSince Feb 9, 2025 Accepting new patients
Ken DME Medical Supplies LLC PastSince May 31, 2020 Accepting new patients
Bass Medical Group Past Accepting new patients
Caremore Health Plan PastSince Sep 1, 2019 Accepting new patients
Tran's Chiropractic,Inc. PastSince Dec 25, 2010 Accepting new patients

Locations

12900 Park Plaza Dr
Fl 7
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

15899 Los Gatos Almaden Rd
Ste 12
Los Gatos, CA 95032
Phone (408) 358-2663

175 N Jackson Ave
Ste 200
San Jose, CA 95116
Phone (408) 384-7160

255 N White Rd
Ste 200
San Jose, CA 95127
Phone (408) 503-7600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1598760373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N JACKSON AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N JACKSON AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161909",
            "telephone_number": "408-384-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISMAN",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E02316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.