Individual provider Active NPI

Heidi C Richter, PA-C , AT-C

  • Physician Assistant
  • Erie, PA
National Provider Identifier
1093788655
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051826 Issued in PA
Practice address
2315 Myrtle St
Suite 160
Erie, PA 16502-4602
Phone
(814) 456-9197
Fax
(814) 455-2765
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT001481A PA
Physician Assistant 363A00000X MA051826 PA Primary

Addresses

Primary practice location

2315 Myrtle St
Suite 160
Erie, PA 16502-4602

Mailing address

1910 Sassafras St
Ste 100
Erie, PA 16502-2716
Phone (814) 456-9197

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000836 PA Practitioner - Physician Assistant 6204895162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
RT001481APAMDAthletic Trainer
MA051826PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants of Erie, Inc. CurrentSince Jan 3, 2011 Accepting new patients
Laser Eye Surgery of Erie, Inc PastSince Oct 21, 1998 Accepting new patients
Fred Jamie W Holland II MD PC Past Accepting new patients

Locations

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

Organizations & group practices 3

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1093788655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST",
            "address_2": "STE 100",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST",
            "address_2": "SUITE 160",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024602",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "HEIDI",
        "middle_name": "C",
        "credential": "PA-C , AT-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001481A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.