Individual provider Active NPI

Craig Heffron, AU.D

  • Audiologist
  • East Patchogue, NY
National Provider Identifier
1053764845
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002670 Issued in NY
Practice address
285 Sills Rd
Building 10, Suite a
East Patchogue, NY 11772-4869
Phone
(631) 207-1119
Fax
(631) 207-2293
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002670 NY Primary

Addresses

Primary practice location

285 Sills Rd
Building 10, Suite a
East Patchogue, NY 11772-4869

Mailing address

285 Sills Rd
Building 10, Suite a
East Patchogue, NY 11772-4869
Phone (631) 207-1119

Other practice location 1

34 Knight Ln
Kings Park, NY 11754-2020
Phone (631) 678-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013000190 NY Practitioner - Qualified Audiologist 9335437052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trailview Audiology, P.C. Audiologist CurrentSince Dec 23, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1053764845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 10, SUITE A",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-207-1119",
            "fax_number": "631-207-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 10, SUITE A",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-207-1119",
            "fax_number": "631-207-2293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Knight Ln",
            "address_purpose": "LOCATION",
            "city": "Kings Park",
            "state": "NY",
            "postal_code": "117542020",
            "country_code": "US",
            "telephone_number": "631-678-7929",
            "fax_number": "631-692-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFFRON",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.