Active NPI
Samuel Donald Heath, PA-C
- Rheumatology Physician
- Willow Grove, PA
National Provider Identifier
1043937089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MA064132
- Practice address
- 2360 Maryland Rd
Willow Grove, PA 19090-1709 - Phone
- (215) 657-6776
- NPI assigned
- Oct 20, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | MA064132 | PA | Primary |
Addresses
Primary practice location
2360 Maryland Rd
Willow Grove, PA 19090-1709
Mailing address
351 Northwood Ave
Elkins Park, PA 19027-1815
Phone (215) 275-9450
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230117000312 | PA | Practitioner - Physician Assistant | 7113398801 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA064132 | PA | MD | Rheumatology Physician |
Interoperability endpoints
- sam.heath.p1@direct.arthritispa.nextgenshare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1043937089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 NORTHWOOD AVE",
"city": "ELKINS PARK",
"state": "PA",
"postal_code": "190271815",
"telephone_number": "215-275-9450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 MARYLAND RD",
"city": "WILLOW GROVE",
"state": "PA",
"postal_code": "190901709",
"telephone_number": "215-657-6776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "SAMUEL",
"middle_name": "DONALD",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "PA",
"license": "MA064132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willow Grove, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.