Heidi S Puc, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

182847 Issued in NY

Practice address

1386 State Route 5 Ste 203
Chittenango, NY 13037-8763

Phone

(315) 741-5774

Fax

(315) 741-5770

NPI assigned

Jan 12, 2006

Last updated

Oct 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1013996545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1386 STATE ROUTE 5 STE 203",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130378763",
            "telephone_number": "315-741-5774",
            "fax_number": "315-741-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1386 STATE ROUTE 5 STE 203",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130378763",
            "telephone_number": "315-741-5774",
            "fax_number": "315-741-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUC",
        "first_name": "HEIDI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "182847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01563675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Chittenango, NY
• Providers in Chittenango, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.