Active NPI
Mark D Heitzmann, D.O.
- Pediatric Radiology Physician
- Bethesda, MD
National Provider Identifier
1154514545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- 0102202287
- Practice address
- 8901 Rockville Pike
Bethesda, MD 20889-5191 - Phone
- (301) 295-5050
- NPI assigned
- Aug 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Radiology Physician | 2085P0229X | 0102202287 | VA | Primary |
Addresses
Primary practice location
8901 Rockville Pike
Bethesda, MD 20889-5191
Mailing address
8901 Rockville Pike
Bethesda, MD 20889-0001
Other practice location 1
Naval Hospital, Camp Pendleton Attn:Code094
Santa Margarita Road, BLDG H100
Camp Pendleton, CA 92055-5191
Phone (760) 725-1394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102202287 | VA | MD | Pediatric Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1154514545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208890001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208895191",
"telephone_number": "301-295-5050"
}
],
"practiceLocations": [
{
"address_1": "Naval Hospital, Camp Pendleton Attn:Code094",
"address_2": "Santa Margarita Road, BLDG H100",
"address_purpose": "LOCATION",
"city": "Camp Pendleton",
"state": "CA",
"postal_code": "920555191",
"country_code": "US",
"telephone_number": "760-725-1394",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEITZMANN",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-20",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "VA",
"license": "0102202287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.