Individual provider Active NPI

Hector Heredia-Martinez Jr., M.D.

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1699882365
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50069 Issued in CA
Practice address
401 H St
Suite 3
Chula Vista, CA 91910-4321
Phone
(619) 420-1010
Fax
(619) 420-1010
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A50069 CA
Internal Medicine Physician 207R00000X A50069 CA Primary

Addresses

Primary practice location

401 H St
Suite 3
Chula Vista, CA 91910-4321

Mailing address

1108 Joshua Creek PL
Chula Vista, CA 91914-2600
Phone (619) 426-1010

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000786 CA Practitioner - Internal Medicine 0749277721 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50069CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hector Heredia, MD a Professional Corporation Internal Medicine CurrentSince Apr 1, 2008 Accepting new patients
James J. Longobardi, DPM, Inc. Current Accepting new patients

Locations

401 H St
Ste 5
Chula Vista, CA 91910
Phone (619) 420-1010

401 H St
Ste 12
Chula Vista, CA 91910

401 H St
Ste 1
Chula Vista, CA 91910
Phone (619) 420-8430

401 H St
Ste 2
Chula Vista, CA 91910
Phone (619) 420-1010

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1699882365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 JOSHUA CREEK PL",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919142600",
            "telephone_number": "619-426-1010",
            "fax_number": "619-426-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 H ST",
            "address_2": "SUITE 3",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104321",
            "telephone_number": "619-420-1010",
            "fax_number": "619-420-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA-MARTINEZ",
        "first_name": "HECTOR",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A50069",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.