Heritage Health – Federally Qualified Health Center (FQHC), NPI 1194397240

Heritage Health is a healthcare provider. based in Hayden, Idaho. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Heritage Health is 1194397240

Main info

Organization
Name
Heritage Health
NPI
1194397240
Phone
(208) 415-0299
Address
PO BOX 1387
Authorized Official
MICHAEL BAKER CEO
Enumeration Date
16 July 2021
Last Update Date
3 November 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness90
Years active:4State licenses:0Digital endpoints

Provider Addresses for Heritage Health

  • PO BOX 1387

    HAYDEN, ID 838351387

    Phone: (208) 415-0299

    Type: Mailing

  • 1221 W IRONWOOD DR STE 100

    COEUR D ALENE, ID 838141402

    Phone: (208) 620-5210

    Fax: (844) 807-3782

    Type: Location

  • 3700 W SELTICE WAY

    COEUR D ALENE, ID 838148921

    Phone: (208) 415-0299

    Fax: (208) 620-3990

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-06-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1047 days ago).

Enrollment records

1

Earliest due date

2023-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20130620000392OFederally Qualified Health Center (Fqhc)ID2023-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83835)

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Reviews

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Frequently asked questions

What number should I use to identify Heritage Health for billing?
Administrative and clinical systems typically use NPI 1194397240 for Heritage Health.
Is Heritage Health currently accepting referrals based on NPI status?
Registry metadata lists Heritage Health as active.
What services align with Heritage Health's listing?
Heritage Health's public classification highlights Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What city is tied to Heritage Health?
The directory associates Heritage Health with Hayden, Idaho. Check all listed addresses for suites or satellite offices.
Can I export Heritage Health's record?
You can download the official NPPES record; we summarize key fields for readability.

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