Individual provider Active NPI

Mariel P Heller-Benson, PA-C

  • Surgical Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1891083408
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA51432 Issued in CA
Practice address
2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone
(925) 939-8585
Fax
(925) 933-2709
NPI assigned
Jul 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5908 GA
Medical Physician Assistant 363AM0700X PA51432 CA
Surgical Physician Assistant 363AS0400X PA51432 CA Primary

Addresses

Primary practice location

2405 Shadelands Dr
Walnut Creek, CA 94598-2444

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

Other names 1

  • Mariel P Heller Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141009002182 CA Practitioner - Physician Assistant 0547439051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

3838 California St
San Francisco, CA 94118-1506

601 Duboce Ave
San Francisco, CA 94117-3389

Hospital & facility affiliations

  • California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
  • Novato Community Hospital Hospital, Novato, CA, CCN 050131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5908GAMDPhysician Assistant
PA51432CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Sep 4, 2014 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Sep 4, 2014 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients

Locations

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

165 Rowland Way
Ste 201
Novato, CA 94945
Phone (415) 600-1817

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

3838 California St
Rm 404
San Francisco, CA 94118
Phone (415) 600-0940

2351 Clay St
Ste 501
San Francisco, CA 94115
Phone (415) 600-3898

4000 Civic Center Dr
Ste 205
San Rafael, CA 94903
Phone (415) 479-7244

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (925) 244-9355

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

Interoperability endpoints

  • Direct secure messaging: mhellerbenson280910@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1891083408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982444",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER-BENSON",
        "first_name": "MARIEL",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-17",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5908",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA51432",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA51432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIEL",
            "last_name": "HELLER",
            "middle_name": "P",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.