Individual provider Active NPI

Daniel R Heitz, MD

  • Diagnostic Radiology Physician
  • Pomona, CA
National Provider Identifier
1962550376
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G71019 Issued in CA
Practice address
1798 N Garey Ave
Pomona, CA 91767-2918
Phone
(909) 865-9535
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G71019 CA Primary

Addresses

Primary practice location

1798 N Garey Ave
Pomona, CA 91767-2918

Mailing address

PO Box 487
Newbury Park, CA 91319-0487
Phone (815) 375-8800

Other identifiers 2

IdentifierTypeStateIssuer
RHL142147OtherCADEPT OF HEALTH SERVICES
00G710190MedicaidCA

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
I20070731000663 CA Practitioner - Diagnostic Radiology 8527159821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Valley Imaging Medical Group IncGroup PAC ID 6709898562, 22 clinicians

Practice addresses (Care Compare)

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71019CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Express Diagnostics, Inc CurrentSince May 25, 2007 Accepting new patients
K & T Diagnostic, Inc. CurrentSince May 25, 2007 Accepting new patients
Pomona Valley Imaging Medical Group Inc CurrentSince Jun 1, 2007 Accepting new patients
St Francis Radiology Medical Group Diagnostic Radiology Past Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology Past Accepting new patients

Locations

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

Organizations & group practices 5

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 3

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962550376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913190487",
            "telephone_number": "815-375-8800",
            "fax_number": "805-375-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672918",
            "telephone_number": "909-865-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZ",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G71019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HEALTH SERVICES",
            "identifier": "RHL142147",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G710190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.