Organization Active NPI

David Heskiaoff MD a Professional Corp

  • Orthopaedic Surgery Physician
  • Sherman Oaks, CA
National Provider Identifier
1629279187
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DAVID HESKIAOFF MD A PROFESSIONAL CORP
Practice address
5170 Sepulveda Blvd
#100
Sherman Oaks, CA 91403-1171
Phone
(818) 784-3878
NPI assigned
May 30, 2007
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Gina Kia
Title
Assistant Controller
Phone
(818) 784-3878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X CA Primary

Addresses

Primary practice location

5170 Sepulveda Blvd
#100
Sherman Oaks, CA 91403-1171

Mailing address

5170 Sepulveda Blvd
#100
Sherman Oaks, CA 91403-1171
Phone (818) 784-3878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603001273 CA Part B Supplier - Clinic/Group Practice 8022090919 Receives reassigned benefits from 2 practitioners
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1629279187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD",
            "address_2": "#100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031171",
            "telephone_number": "818-784-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD",
            "address_2": "#100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031171",
            "telephone_number": "818-784-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID HESKIAOFF MD A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "KIA",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "818-784-3878"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.