Individual provider Active NPI

Robert Adam Heifetz, DO

  • Family Medicine Physician
  • Davis, CA
National Provider Identifier
1629538434
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A25123 Issued in CA
Practice address
2660 W Covell Blvd Ste Abandc
Davis, CA 95616-5645
Phone
(530) 747-3000
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A25123 CA Primary

Addresses

Primary practice location

2660 W Covell Blvd Ste Abandc
Davis, CA 95616-5645

Mailing address

2660 W Covell Blvd
Davis, CA 95616-5645
Phone (301) 602-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230818001648 NC Practitioner - Family Practice 3476984774
I20250725004336 AR Practitioner - Family Practice 3476984774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A25123CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springdale- Bentonville HBP Services, LLC CurrentSince Jul 16, 2025 Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1629538434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W COVELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165645",
            "telephone_number": "301-602-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W COVELL BLVD STE ABANDC",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165645",
            "telephone_number": "530-747-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIFETZ",
        "first_name": "ROBERT",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A25123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.