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NATHAN JOHN WILSON HEACOCK CRNA
NPI 1881155836
Nurse Anesthetist, Certified Registered in Stockton, CA

Active since March 30, 2019Accepts Medicare Assignment
81.56/100
CMS Quality Rating
1800 N CALIFORNIA ST, STOCKTON, CA 95204(209) 943-2000 Get Directions Write a Review

NPPES record last updated: August 13, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nathan John Wilson Heacock Crna NPPES

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

NATHAN JOHN WILSON HEACOCK CRNA (NPI 1881155836) is an individual nurse anesthetist, certified registered in Stockton, California, licensed in California (95001167) and active in the NPI registry since March 2019. He is a graduate of Other (2019).

NPPES Registry Identity

NPI1881155836
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameNATHAN JOHN WILSON HEACOCKCredential: CRNA
Location Address1800 N CALIFORNIA STStockton, CA 95204-6019
Mailing Address9687 Marquis CtElk Grove, CA 95758-4674 · (530) 957-6828
Phone(209) 943-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 30, 2019
Last NPPES UpdateAugust 13, 2019
✔ NPI 1881155836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 95001167
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License RN95178472 (CA)
1800 N CALIFORNIA ST, Stockton, CA 95204
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathan John Wilson Heacock Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183954761
PECOS Enrollment IDI20190924003302

Medicare Billing Reassignments

6

Medicare enrollment records show Nathan Heacock reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
3.3 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000
Sutter Valley Medical Foundation
4.8 mi
Ambulatory Surgical
8011 DON AVE
Stockton, CA 95209
NPI 1467825844 (209) 955-3001
Anesthesia Services Of San Joaquin, P.C.
5.8 mi
Anesthesiology
500 W HOSPITAL RD
French Camp, CA 95231
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Anesthesia Services Of San Joaquin PC
  • 217 clinicians in this Medicare group
NPI 1366778227 (877) 580-3144
El Dorado Anesthesia Medical Group
59 mi
Anesthesiology
1100 MARSHALL WAY
Placerville, CA 95667
  • Reassigned Medicare billing, California enrollment
  • 19 clinicians in this Medicare group
NPI 1356390983 (530) 622-1441
Mountain Communities Healthcare District
210 mi
Critical Access
60 EASTER AVENUE
Weaverville, CA 96093
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1407027568 (California)
  • 119 clinicians in this Medicare group
NPI 1750462271 (530) 623-5541
Palm Springs Anesthesia Services, PC
347 mi
Anesthesiology
2101 N WATERMAN AVE
San Bernardino, CA 92404
  • Reassigned Medicare billing, California enrollment
  • 270 clinicians in this Medicare group
NPI 1083928501 (914) 491-9495

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95204 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

DEEPAK GIR MD
Student in an Organized Health Care Education/Training Program
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 547-7177
PRIYADEEP KANG MD
Student in an Organized Health Care Education/Training Program
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 547-7181
NANCY THI NGUYEN CF-SLP
Speech-Language Pathologist
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 943-2000
DR. VALERIE DEJESUS MD
Anesthesiology
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 547-5716
LARRY GEORGE OTTERSTETTER DO
Student in an Organized Health Care Education/Training Program
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 547-7181
SHUBHPREET KAUR SOHAL
Nurse Practitioner (Family)
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 466-0456
RONLI LEVI RD
Dietitian, Registered
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 467-5356
JOSEPH HOWARD HOFFMAN DO
Emergency Medicine
1800 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 943-2000

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 Nathan Heacock's NPI number?

The NPI number for Nathan Heacock is 1881155836. It was assigned to this individual provider in the NPPES registry on March 30, 2019.

Where is Nathan Heacock located?

Nathan Heacock practices at 1800 N California St, Stockton, CA 95204. The listed phone number is (209) 943-2000.

What is Nathan Heacock's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Nathan Heacock enrolled in Medicare?

Yes. Nathan Heacock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nathan Heacock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nathan Heacock reassigns Medicare benefits to 6 organizations: Permanente Medical Group Inc (Stockton, CA), Sutter Valley Medical Foundation (Stockton, CA), Anesthesia Services Of San Joaquin, P.C. (French Camp, CA), El Dorado Anesthesia Medical Group (Placerville, CA), Mountain Communities Healthcare District (Weaverville, CA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nathan Heacock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nathan Heacock was last updated on August 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.