Gary David Heitzler, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

044619 Issued in NY

Practice address

615 Broadway
Hastings on Hudson, NY 10706-1039

Phone

(914) 478-8585

Fax

(914) 478-5797

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJCDAA/Endpoint/CJCDAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Damian Family Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
  • NPI 1508955592
  Medicare reassignment NPD
• Damian Family Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
  • NPI 1487923595
  NPD
• Damian Family Care Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1922857267
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003031824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 BROADWAY",
            "city": "HASTINGS ON HUDSON",
            "state": "NY",
            "postal_code": "107061039",
            "telephone_number": "914-478-8585",
            "fax_number": "914-478-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BROADWAY",
            "city": "HASTINGS ON HUDSON",
            "state": "NY",
            "postal_code": "107061039",
            "telephone_number": "914-478-8585",
            "fax_number": "914-478-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZLER",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "044619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Marion Grill, LCSW MSW
• Eric Ben Grossman, MD
• Hastings Podiatry Associates, LLP
• Hastings-on-Hudson Union Free School District
• Kimberly Michele Havel, OTR/L
• Fay Henry, R.N.
• Robin Herbert, M.D,
• Vanessa Hernandez, PA
• Tamar Hoff-Nir, DDS
• Charlene Holmes

• Pediatric Dentistry in Hastings on Hudson, NY
• Providers in Hastings on Hudson, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.