Active NPI
Heather Bennett Schickedanz, M.D.
- Family Medicine Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A115878
- Practice address
- 1250 16TH St Ste A454
Sfvamc BLDG 1, 300. Mail 181G.
Santa Monica, CA 90404-1249 - Phone
- (310) 319-4698
- NPI assigned
- Dec 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A115878 | CA | Primary |
| Hospitalist Physician | 208M00000X | A115878 | CA | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | A115878 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1250 16TH St Ste A454
Sfvamc BLDG 1, 300. Mail 181G.
Santa Monica, CA 90404-1249
Mailing address
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 319-4698
Other names 1
- Heather Dawn Bennett
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of California, San Francisco School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12021 S Wilmington Ave
Room 1059
Los Angeles, CA 90059-3019
14445 Olive View Dr
Sylmar, CA 91342-1437
Phone (818) 364-3001
Hospital & facility affiliations
- Healthy Palace Home Health Care, Inc
- Lac/Harbor-UCLA Med Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120407 | CA | MD | Marriage & Family Therapist |
| A115878 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Los Angeles | Current | Accepting new patients | |
| County of Los Angeles Auditor Controller | Current | Accepting new patients | |
| County of Los Angeles | Current | Accepting new patients | |
| Regents Univ of Calif Los Angeles | Past | Accepting new patients |
Locations
14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Torrance, CA
- NPI 1851363188
-
- Clinic/Center
- Los Angeles, CA
- NPI 1295407401
-
- General Acute Care Hospital
- Sylmar, CA
- NPI 1134159320
-
- Psychiatric Hospital
- Los Angeles, CA
- NPI 1952308363
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Torrance, CA
- NPI 1477574838
-
- Home Health Agency
- Van Nuys, CA
- NPI 1487235792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424822400000",
"number": "1679875223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631",
"telephone_number": "310-319-4698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 16TH ST STE A454",
"address_2": "SFVAMC BLDG 1, 300. MAIL 181G.",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041249",
"telephone_number": "310-319-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHICKEDANZ",
"first_name": "HEATHER",
"middle_name": "BENNETT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-01",
"last_updated": "2015-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A115878",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A115878",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "CA",
"license": "A115878",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "BENNETT",
"middle_name": "DAWN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.