Individual provider Active NPI

Heather Denean Mahoney, M.D.

  • Family Medicine Physician
  • Wynnewood, PA
National Provider Identifier
1003137332
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD449022 Issued in PA
Practice address
100 E Lancaster Ave Ste 353
Wynnewood, PA 19096-3433
Phone
(445) 216-3374
Fax
(610) 642-2802
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD449022 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 353
Wynnewood, PA 19096-3433

Mailing address

300 E Lancaster Ave Ste 400
Wynnewood, PA 19096-2139
Phone (610) 642-2002

Other names 1

  • Heather Denean Swanson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130913000364 PA Practitioner - Family Practice 0648414698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 E Lancaster Ave
Suite 353
Wynnewood, PA 19096-3433
Phone (445) 216-3374

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD449022PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Mar 9, 2015 Accepting new patients
HDM Wellness LLC Family Medicine CurrentSince Jul 31, 2024 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

306 E Lancaster Ave
Ste 400
Wynnewood, PA 19096
Phone (484) 476-7222

100 E Lancaster Ave
Ste 353
Wynnewood, PA 19096
Phone (610) 649-9021

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

Interoperability endpoints

  • Direct secure messaging: heather.mahoney.1@14222.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1003137332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LANCASTER AVE STE 400",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962139",
            "telephone_number": "610-642-2002",
            "fax_number": "610-642-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 353",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963433",
            "telephone_number": "445-216-3374",
            "fax_number": "610-642-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "HEATHER",
        "middle_name": "DENEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD449022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "SWANSON",
            "middle_name": "DENEAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.