Individual provider Active NPI

Benjamin Joseph Heinzen, M.D.

  • Internal Medicine Physician
  • Oshkosh, WI
National Provider Identifier
1083886733
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55367-020 Issued in WI
Practice address
1855 S Koeller St
Oshkosh, WI 54902-6214
Phone
(920) 223-7100
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55367-020 WI Primary

Addresses

Primary practice location

1855 S Koeller St
Oshkosh, WI 54902-6214

Mailing address

1855 South Koeller St
Affinity Medical Group
Oshkosh, WI 54904
Phone (920) 223-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110803000793 WI Practitioner - Internal Medicine 8022287291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200

1420 Algoma St
New London, WI 54961-2104
Phone (920) 982-8300

1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 738-2000

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

1855 S Koeller St
Oshkosh, WI 54902-6186
Phone (920) 223-7000

2700 W 9TH Ave
Oshkosh, WI 54904-7247

3329 N Richard St
Appleton, WI 54911-1063
Phone (920) 380-2715

500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone (920) 223-2000

916 E Main St
Winneconne, WI 54986-9782
Phone (920) 582-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55367-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 22, 2011 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 22, 2011 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1855 S Koeller St
Oshkosh, WI 54902
Phone (920) 223-7010

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 2

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 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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1083886733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SOUTH KOELLER ST",
            "address_2": "AFFINITY MEDICAL GROUP",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-223-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026214",
            "telephone_number": "920-223-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZEN",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "55367-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.