1. Home
  2. Directory
  3. California
  4. San Luis Obispo
  5. Physician Assistant
  6. NPI Profile

MRS. TINA LISA HECK PA-C
NPI 1003048620
Physician Assistant in San Luis Obispo, CA

Active since August 14, 2009PECOS Enrolled
77 CASA ST STE 201, SAN LUIS OBISPO, CA 93405(805) 269-1500 Get Directions Write a Review

NPPES record last updated: June 11, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Tina Lisa Heck Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. TINA LISA HECK PA-C (NPI 1003048620) is an individual physician assistant in San Luis Obispo, California, licensed in California (PA20461) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003048620
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. TINA LISA HECKCredential: PA-C
Location Address77 CASA ST STE 201San Luis Obispo, CA 93405-5806
Mailing Address2050 S Blosser RdSanta Maria, CA 93458-7310 · (805) 361-8028 · Fax (805) 361-8097
Phone(805) 269-1500
Sole ProprietorNo
Enumeration DateAugust 14, 2009
Last NPPES UpdateJune 11, 2015
✔ NPI 1003048620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA20461
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
77 CASA ST STE 201, San Luis Obispo, CA 93405
Open in Google Maps ↗

Other Names 1

Former Name (1)Tina Lisa Pravongviengkham

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Tina Lisa Heck Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.64 typical visit price
range $59.84 – $178.89
Typical copayment $22.91 (range $14.96 – $44.72)
Most-billed visit code 99203
Established Patient
$74.24 typical visit price
range $19.70 – $146.55
Typical copayment $18.56 (range $4.92 – $36.63)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANN L BOLLAY MD
Hospitalist
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1566
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC
Clinic/Center (Community Health)
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500
SUSAN CELLI
Dietitian, Registered
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500
DR. KAISHAWN D. MCDUFFIE NP
Nurse Practitioner
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500
JONAS MORALES NP
Nurse Practitioner
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 269-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tina Heck's NPI number?

The NPI number for Tina Heck is 1003048620. It was assigned to this individual provider in the NPPES registry on August 14, 2009. The provider is also known as Tina Lisa Pravongviengkham.

Where is Tina Heck located?

Tina Heck practices at 77 Casa St Ste 201, San Luis Obispo, CA 93405. The listed phone number is (805) 269-1500.

What is Tina Heck's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tina Heck enrolled in Medicare?

Yes. Tina Heck is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tina Heck was last updated on June 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.