Cody Janton Heintzelman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9121574 Issued in FL

Practice address

270 Susquehanna Valley Mall Dr Ste 800
Selinsgrove, PA 17870-9124

Phone

(570) 884-7925

Fax

(570) 374-7932

NPI assigned

Oct 16, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellspan Hospice Services Hospice, Lewisburg, PA, CCN 391545
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
• Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013
• Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: codyheintzelmanpac@fpc.medentdirect.com

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.

• Family Practice Center, PC

  • Physical Therapist
  • Middleburg, PA
  • NPI 1154376937

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Evangelical Community Hospital

  dba WellSpan Evangelical Community Hospital

  • General Acute Care Hospital
  • Lewisburg, PA
  • NPI 1124076039
  Care Compare affiliation
• Evangelical Community Hospital

  dba WellSpan Hospice Services

  • Community Based Hospice Care Agency
  • Lewisburg, PA
  • NPI 1720046519
  Care Compare affiliation
• Adventhealth Palm Coast Parkway Inc

  dba Adventhealth Palm Coast Parkway

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1861102345
  Care Compare affiliation
• Memorial Hospital Flagler Inc

  dba AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1174034359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL MEDICAL PKWY STE 101",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645979",
            "telephone_number": "386-586-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 SUSQUEHANNA VALLEY MALL DR STE 800",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178709124",
            "telephone_number": "570-884-7925",
            "fax_number": "570-374-7932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Memorial Medical Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321645979",
            "country_code": "US",
            "telephone_number": "386-586-1523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINTZELMAN",
        "first_name": "CODY",
        "middle_name": "JANTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121574",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059718",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "704830",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103601590",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "codyheintzelmanpac@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "21 Susquehanna Valley Mall Dr Ste D",
            "city": "Selinsgrove",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178709148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Ann Hain
• Rebecca Lynn Hall, LAT, ATC
• Janice Marie Kazar Harris, PTA
• Cassie Jo Harshberger, PA-C
• Rebecca Lee Hartranft, DPT, CERT. MDT
• Henry G. Yavorek, MD, Facs
• Ellie Herman, LCSW
• Richard T Herman, D.M.D.
• Morgan A Herold, ATC
• Valera Morningstar Hess, O.D.

• Physician Assistant in Selinsgrove, PA
• Providers in Selinsgrove, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.