NPIMap

Individual provider Active NPI

Matthew Heffernan

  • Cardiovascular Disease Physician
  • Lebanon, PA
National Provider Identifier
1033646955
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS019593 Issued in PA
Practice address
775 Norman Dr
Lebanon, PA 17042-7497
Phone
(717) 274-5500
Fax
(717) 274-5189
NPI assigned
May 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS019593 PA
Cardiovascular Disease Physician 207RC0000X OS019593 PA Primary

Addresses

Primary practice location

775 Norman Dr
Lebanon, PA 17042-7497

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 274-5500

Other practice location 1

1400 S Forge Rd Ste 4
Palmyra, PA 17078-9519
Phone (717) 274-5500

Other identifiers 2

IdentifierTypeStateIssuer
390200000XMedicaidPA
103359655MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201005002255 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0143592931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

775 Norman Dr
Wellspan Cardiology
Lebanon, PA 17042-7497
Phone (717) 274-5500

Hospital & facility affiliations

  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066
  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Hospitalist Services LLC Internal Medicine CurrentSince Jul 2, 2020 Accepting new patients
Wellspan Medical Group CurrentSince Jul 17, 2023 Accepting new patients
Wellspan Medical Group CurrentSince Jul 17, 2023 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

4830 Londonderry Rd
Harrisburg, PA 17109
Phone (717) 657-2595

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

775 Norman Dr
Lebanon, PA 17042
Phone (717) 274-5500

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

1400 S Forge Rd
Ste 4
Palmyra, PA 17078
Phone (717) 274-5500

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: mheffernan306280@wellspan.direct-ci.com

Organizations & group practices 5

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 11

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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1033646955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-274-5500",
            "fax_number": "717-274-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427497",
            "telephone_number": "717-274-5500",
            "fax_number": "717-274-5189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Forge Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Palmyra",
            "state": "PA",
            "postal_code": "170789519",
            "country_code": "US",
            "telephone_number": "717-274-5500",
            "fax_number": "717-274-5189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019593",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS019593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390200000X",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103359655",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.