Individual provider Active NPI

Heidi McNulty, DO

  • Family Medicine Physician
  • Davis, CA
National Provider Identifier
1770672859
Registry record updated Jul 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A14014 Issued in CA
Practice address
2660 W Covell Blvd
Davis, CA 95616-5645
Phone
(540) 747-3000
NPI assigned
Oct 12, 2006
Last updated
Jul 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2021

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 20A14014 CA Primary

Addresses

Primary practice location

2660 W Covell Blvd
Davis, CA 95616-5645

Mailing address

2440 W Covell Blvd
Davis, CA 95616-5671
Phone (530) 747-3095

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
I20150926000301 CA Practitioner - Family Practice 8123098423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3160 Folsom Blvd
Suite 2500
Sacramento, CA 95816-5267
Phone (916) 734-7777

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14014CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Nov 1, 2015 Accepting new patients
Regents of the University of California CurrentSince Nov 1, 2015 Accepting new patients
US Dept of HHS Family Medicine Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

7551 Madison Ave
Citrus Hts, CA 95610
Phone (916) 904-3000

2440 W Covell Blvd
Davis, CA 95616
Phone (530) 668-2646

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

1535 River Park Dr
Ste 2000
Sacramento, CA 95815
Phone (916) 286-1010

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

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, 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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1770672859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 W COVELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165671",
            "telephone_number": "530-747-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W COVELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165645",
            "telephone_number": "540-747-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "HEIDI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.