Individual provider Active NPI

Samuel Allen Heathcote Sr., MD

  • Surgery Physician
  • Pinehurst, NC
National Provider Identifier
1063808046
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2020-00609 Issued in NC
Practice address
5 First Village Dr
Pinehurst, NC 28374-9495
Phone
(910) 295-6831
Fax
(910) 295-0244
NPI assigned
Apr 7, 2015
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2020-00609 NC Primary

Addresses

Primary practice location

5 First Village Dr
Pinehurst, NC 28374-9495

Mailing address

PO Box 2000
Pinehurst, NC 28374-2000
Phone (910) 295-6831

Other names 1

  • Dr. Samuel Allen Heathcote Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707000566 NC Practitioner - General Surgery 2264746338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCPC-9 LLCGroup PAC ID 1658526710, 57 clinicians
Pinehurst Surgical Clinic PAGroup PAC ID 4587561394, 92 clinicians

Practice addresses (Care Compare)

2919 Beechtree Dr
Suite 2100
Sanford, NC 27330-6934
Phone (910) 417-4096

5 1St Village Dr
Pinehurst, NC 28374-9495
Phone (910) 295-6831

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy56
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-00609NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-9, LLC Multi-Specialty CurrentSince Jun 15, 2021 Accepting new patients
Pinehurst Surgical Clinic PA Multi-Specialty CurrentSince Jun 15, 2021 Accepting new patients
MCPC-20, LLC Multi-Specialty PastSince Jun 15, 2021 Accepting new patients
Pinehurst Surgical Clinic PA Multi-Specialty PastSince Sep 20, 2022 Accepting new patients

Locations

208 W Salisbury St
Ste A
Asheboro, NC 27203
Phone (336) 523-0040

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

6322 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6700

809 S Long Dr
Ste K
Rockingham, NC 28379
Phone (910) 417-4090

921 S Long Dr
Ste 208
Rockingham, NC 28379
Phone (910) 417-3396

522 Allen St
Ste 201
Troy, NC 27371
Phone (910) 215-1000

Interoperability endpoints

  • Direct secure messaging: samuelheathcote@fhss.allscriptsdirect.net
  • Direct secure messaging: samuelheathcote@psc.allscriptsdirect.net

Organizations & group practices 4

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 4

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1063808046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283742000",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRST VILLAGE DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749495",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHCOTE",
        "first_name": "SAMUEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2020-00609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "HEATHCOTE",
            "middle_name": "ALLEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.