MEDICARE: HERITAGE ACADEMY GATEWAY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1225913577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE ACADEMY GATEWAY, INC.

Provider Business Mailing Address
First Line	:	43 E 1ST AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-1446
Country	:	US
Telephone Number	:	480-461-4405
Fax Number	:

Provider Business Practice Location Address
First Line	:	8048 E GERMANN RD BLDG 4
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-5302
Country	:	US
Telephone Number	:	480-461-4400
Fax Number	:	480-498-5073

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	BRANDON BERNARD
Credential	:
Telephone Number	:	480-461-4425

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

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