Michael P Heffernan (NPI# 1518923432, PAC ID# 1456371459) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1518923432 |
| PAC ID by PECOS | 1456371459 |
| Professional Enrollment ID | I20140718000651 |
| Full Name | Michael P Heffernan |
| Organization Legal Name | SAN LUIS DERMATOLOGY AND LASER CLINIC INC |
| Address |
15 Santa Rosa St San Luis Obispo CA 93405-1811 |
| Phone Number | 8055412650 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 1993 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 5496700767 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050107 | MARIAN REGIONAL MEDICAL CENTER |
| 050232 | FRENCH HOSPITAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 8055412650 | SAN LUIS DERMATOLOGY AND LASER CLINIC INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 100% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_265_overall | Biopsy Follow-Up | 100% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 94% |
| Organization Legal Name | SAN LUIS DERMATOLOGY AND LASER CLINIC INC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles B Fishman | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Robert Jeffrey Herten | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Joseph W Diehl | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Cheryl Ketelsen | Physician Assistant | San Luis Dermatology and Laser Clinic Inc | 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401-4663 |
| Street Address |
15 SANTA ROSA ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip | 93405-1811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles B Fishman | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Robert Jeffrey Herten | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Joseph W Diehl | Dermatology | San Luis Dermatology and Laser Clinic Inc | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William F D Ambruoso | Internal Medicine | 179 Twin Ridge Rd, San Luis Obispo, CA 93405 | |
| Amanda Michelle Parreira | Optometry | 894 Meinecke Ave A, San Luis Obispo, CA 93405-1790 | |
| Tyrone G Mcsorley | Physical Therapy | 894 Meinecke Ave, Suite B, San Luis Obispo, CA 93405-1791 | |
| Julie L Mcsorley | Physical Therapy | 894 Meinecke Ave, Suite B, San Luis Obispo, CA 93405-1791 | |
| Harold D Segal | Neurosurgery | 140 Casa St, San Luis Obispo, CA 93405-1804 | |
| Gayle S Cekada | Internal Medicine | 184 Casa St, San Luis Obispo, CA 93405-1804 | |
| Stephen A Hilty | Internal Medicine | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Eric W Dunlop | General Practice | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Ginger Christianne Cochran | Registered Dietitian Or Nutrition Professional | 148 Casa St, San Luis Obispo, CA 93405-1804 | |
| Kristina N Dilworth | Nurse Practitioner | First Choice Physician Partners | 1064 Murray Ave, San Luis Obispo, CA 93405-1806 |
| Find all physicians in zip 93405 | |||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
| Specialty | DERMATOLOGY |
| City + Specialty | SAN LUIS OBISPO + DERMATOLOGY |
Please comment or provide details below to improve the information on Michael P Heffernan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.