Individual provider Active NPI

Heather Marie Wertz, NP-C

  • Family Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1225575087
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008686A Issued in IN
Practice address
16100 Sand Canyon Ave
St 130
Irvine, CA 92618-3716
Phone
(949) 417-1100
NPI assigned
Jan 31, 2017
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95004206 CA
Family Nurse Practitioner 363LF0000X 71008686A IN Primary

Addresses

Primary practice location

16100 Sand Canyon Ave
St 130
Irvine, CA 92618-3716

Mailing address

16100 Sand Canyon Ave
St 130
Irvine, CA 92618-3716

Other practice location 1

7979 N Shadeland Ave Ste 100
Indianapolis, IN 46250-2042
Phone (317) 621-4300

Other identifiers 1

IdentifierTypeStateIssuer
300023262MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hwertz340004@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190401001510 IN Practitioner - Nurse Practitioner 1355624271 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95004206CAMDFamily Nurse Practitioner
71008686AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince May 20, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince May 20, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7979 N Shadeland Ave
Ste 100
Indianapolis, IN 46250
Phone (317) 621-4300

Interoperability endpoints

  • Direct secure messaging: hwertz340004@ecommunitydirect.com

Organizations & group practices 3

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": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1225575087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "ST 130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "ST 130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183716",
            "telephone_number": "949-417-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7979 N Shadeland Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502042",
            "country_code": "US",
            "telephone_number": "317-621-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERTZ",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004206",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008686A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023262",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwertz340004@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7979 N Shadeland Ave Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.