Individual provider Active NPI

Kimberly F Heller, MD

  • Emergency Medicine Physician
  • Madison Heights, MI
National Provider Identifier
1093749475
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301099496 Issued in MI
Practice address
27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone
(248) 967-7661
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 67274 AZ
Emergency Medicine Physician 207P00000X 48139 MN
Emergency Medicine Physician 207P00000X 4301099496 MI Primary

Addresses

Primary practice location

27351 Dequindre Rd
Madison Heights, MI 48071-3487

Mailing address

17717 Masonic
Fraser, MI 48026-3158

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kheller1800541@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120124000074 MI Practitioner - Emergency Medicine 9931112992 Reassigns benefits to 4 organizations
I20221014002814 AZ Practitioner - Emergency Medicine 9931112992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

  • Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67274AZMDEmergency Medicine Physician
4301099496MIMDEmergency Medicine Physician
48139MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Department Physicians, P.C. Emergency Medicine CurrentSince Sep 1, 2012 Accepting new patients
Mayo Clinic Arizona CurrentSince Sep 21, 2022 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 2012 Accepting new patients
Mayo Clinic Arizona CurrentSince Sep 21, 2022 Accepting new patients
Observation Emergency Physicians, P.C. Emergency Medicine CurrentSince Sep 1, 2012 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Hennepin Faculty Associates Past Accepting new patients
Hennepin Faculty Associates Past Accepting new patients
Hennepin Healthcare System, Inc Past Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

17717 Masonic
Fraser, MI 48026
Phone (586) 294-0600

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 11

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 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1093749475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17717 MASONIC",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480263158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "248-967-7661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595499",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELLER",
        "first_name": "KIMBERLY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "67274",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "48139",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301099496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kheller1800541@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.