NPIMap

Individual provider Active NPI

Brenten Lance Heeke, M.D.

  • Diagnostic Radiology Physician
  • Birmingham, AL
National Provider Identifier
1033538103
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD.34747 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249-6830
Phone
(205) 934-3166
NPI assigned
Apr 15, 2014
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD.34747 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249-6830

Mailing address

619 19TH St S
Birmingham, AL 35249-6830
Phone (205) 934-3166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923003050 AL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9032405816 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Medical College of Georgia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Selma Radiology Associates P CGroup PAC ID 3870497720, 28 clinicians
Alabama Imaging PCGroup PAC ID 2365341328, 32 clinicians
Montgomery Radiology Associates PAGroup PAC ID 2961301999, 39 clinicians

Practice addresses (Care Compare)

1015 Medical Ctr Pkwy
Selma, AL 36701-6748
Phone (334) 418-4100

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 269-6337

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 288-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Selma Radiology Associates P C CurrentSince Jul 1, 2020 Accepting new patients
Alabama Imaging PC CurrentSince Jul 1, 2020 Accepting new patients

Locations

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

2055 Normandie Dr
Ste 200
Montgomery, AL 36111
Phone (205) 262-0655

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

1015 Medical Center Pkwy
Selma, AL 36701
Phone (334) 418-4100

Organizations & group practices 3

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

Hospital & facility affiliations 5

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1033538103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496830",
            "telephone_number": "205-934-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496830",
            "telephone_number": "205-934-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEKE",
        "first_name": "BRENTEN",
        "middle_name": "LANCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "MD.34747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.