Individual provider Active NPI

Corey A Heichel, P.A.-C.

  • Medical Physician Assistant
  • Lake Mary, FL
National Provider Identifier
1134319601
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2134 Issued in SC
Practice address
795 Primera Blvd Ste 1001
Lake Mary, FL 32746-2191
Phone
(386) 561-9967
Fax
(844) 815-1446
NPI assigned
Jul 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2134 SC
Medical Physician Assistant 363AM0700X 2134 SC Primary

Addresses

Primary practice location

795 Primera Blvd Ste 1001
Lake Mary, FL 32746-2191

Mailing address

795 Primera Blvd Ste 1001
Lake Mary, FL 32746-2191
Phone (386) 561-9967

Other identifiers 1

IdentifierTypeStateIssuer
1944PAMedicaidSC

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000059 FL Practitioner - Physician Assistant 3577716125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Central Florida Rheumatology Consultants LLCGroup PAC ID 7214276922, 9 clinicians

Practice addresses (Care Compare)

759 Harley Strickland Blvd
Orange City, FL 32763-7954

915 Harley Strickland Blvd
Orange City, FL 32763-7967
Phone (386) 561-9967

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2134SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Rheumatology Consultants LLC Current Accepting new patients

Locations

795 Primera Blvd
Ste 1001
Lake Mary, FL 32746
Phone (386) 561-9967

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1134319601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 PRIMERA BLVD STE 1001",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462191",
            "telephone_number": "386-561-9967",
            "fax_number": "844-815-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 PRIMERA BLVD STE 1001",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462191",
            "telephone_number": "386-561-9967",
            "fax_number": "844-815-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEICHEL",
        "first_name": "COREY",
        "middle_name": "A",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2134",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1944PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.