Individual provider Active NPI

Pamela Heiple, O.D.

  • Optometrist
  • Melbourne, FL
National Provider Identifier
1093883613
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC002725 Issued in FL
Practice address
1700 W New Haven Ave
Jcpenney Optical
Melbourne, FL 32904-3919
Phone
(321) 727-8807
Fax
(321) 676-1541
NPI assigned
Dec 1, 2006
Last updated
Feb 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC002725 FL Primary
Optometrist 152W00000X 4813 TX

Addresses

Primary practice location

1700 W New Haven Ave
Jcpenney Optical
Melbourne, FL 32904-3919

Mailing address

3330 Westland
Melbourne, FL 32934-7859
Phone (321) 508-0793

Other names 1

  • Dr. Pamela R. Heiple Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101209000158 FL Practitioner - Optometry 6901093509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4813TXMDMarriage & Family Therapist
OPC002725FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Pamela R. Heiple P.a. Optometrist CurrentSince Jun 7, 1999 Accepting new patients

Locations

2700 Clearlake Rd
Cocoa, FL 32922
Phone (321) 631-0373

1700 W New Haven Ave
Melbourne, FL 32904
Phone (321) 725-4948

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1093883613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 WESTLAND",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347859",
            "telephone_number": "321-508-0793",
            "fax_number": "321-676-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W NEW HAVEN AVE",
            "address_2": "JCPENNEY OPTICAL",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043919",
            "telephone_number": "321-727-8807",
            "fax_number": "321-676-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIPLE",
        "first_name": "PAMELA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002725",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "HEIPLE",
            "middle_name": "R.",
            "prefix": "DR.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.