Individual provider Active NPI

Heidemarie Ernst, M.D.

  • Psychiatry Physician
  • Menlo Park, CA
National Provider Identifier
1790819472
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A73163 Issued in CA
Practice address
1220 University Dr Ste 103
Menlo Park, CA 94025-4265
Phone
(650) 323-1317
NPI assigned
Mar 15, 2007
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A73163 CA Primary

Addresses

Primary practice location

1220 University Dr Ste 103
Menlo Park, CA 94025-4265

Mailing address

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 363-4111

Other practice location 1

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 363-4111

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
I20041227000638 CA Practitioner - Psychiatry 9638137433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 573-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73163CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Solutions for Children, Families and Individuals CurrentSince Dec 21, 2016 Accepting new patients
County of San Mateo CurrentSince Jul 1, 2009 Accepting new patients
Community Solutions for Children, Families, and Individuals CurrentSince Dec 21, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
San Mateo County Psychiatry CurrentSince Jul 1, 2009 Accepting new patients
Community Solutions for Children, Families and Individuals Current Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8648

9015 Murray Ave
Ste 100
Gilroy, CA 95020
Phone (408) 665-4908

225 Cabrillo Hwy S
Half Moon Bay, CA 94019
Phone (650) 726-0211

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 6

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1790819472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 BREWSTER AVE",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631510",
            "telephone_number": "650-363-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR STE 103",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254265",
            "telephone_number": "650-323-1317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Brewster Ave",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940631510",
            "country_code": "US",
            "telephone_number": "650-363-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERNST",
        "first_name": "HEIDEMARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A73163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.