Individual provider Active NPI

Kevin N Heller, MD

  • Pediatric Hematology & Oncology Physician
  • Beltsville, MD
National Provider Identifier
1215566591
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
220206 Issued in NY
Practice address
9000 Virginia Manor Rd Ste 200
Beltsville, MD 20705-4214
Phone
(240) 479-2719
NPI assigned
Apr 7, 2020
Last updated
Apr 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 220206 NY Primary

Addresses

Primary practice location

9000 Virginia Manor Rd Ste 200
Beltsville, MD 20705-4214

Mailing address

9000 Virginia Manor Rd Ste 200
Beltsville, MD 20705-4214
Phone (240) 479-2719

Other practice location 1

12004 Trailridge Dr
Potomac, MD 20854-2838
Phone (646) 530-4551

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 Medicine

State licenses

LicenseStateTypeSpecialty
220206NYMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1215566591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 VIRGINIA MANOR RD STE 200",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207054214",
            "telephone_number": "240-479-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 VIRGINIA MANOR RD STE 200",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207054214",
            "telephone_number": "240-479-2719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12004 Trailridge Dr",
            "address_purpose": "LOCATION",
            "city": "Potomac",
            "state": "MD",
            "postal_code": "208542838",
            "country_code": "US",
            "telephone_number": "646-530-4551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELLER",
        "first_name": "KEVIN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NY",
            "license": "220206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.