Blake Heinonen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004922RX Issued in OH

Practice address

903 Lincoln Dr
Conneaut, OH 44030-2137

Phone

(440) 813-7665

NPI assigned

Nov 21, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  OH

  Medicare reassignment Care Compare group NPD
• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353

  OH

  Medicare reassignment
• The Cleveland Clinic Foundation

  • Eyewear Supplier
  • Avon Lake, OH
  • NPI 1104334226
  Care Compare group
• The Cleveland Clinic Foundation

  • Eyewear Supplier
  • North Ridgeville, OH
  • NPI 1245748300
  Care Compare group
• The Cleveland Clinic Foundation

  • Durable Medical Equipment & Medical Supplies
  • Oberlin, OH
  • NPI 1265537179
  Care Compare group
• The Cleveland Clinic Foundation

  • Clinic Pharmacy
  • Strongsville, OH
  • NPI 1295717593
  Care Compare group
• The Cleveland Clinic Foundation

  • Eyewear Supplier
  • Akron, OH
  • NPI 1326175183
  Care Compare group
• The Cleveland Clinic Foundation

  • Clinic Pharmacy
  • Willoughby Hills, OH
  • NPI 1346348091
  Care Compare group
• The Cleveland Clinic Foundation

  • Durable Medical Equipment & Medical Supplies
  • Cleveland, OH
  • NPI 1497882690
  Care Compare group
• The Cleveland Clinic Foundation

  • Clinic Pharmacy
  • Sandusky, OH
  • NPI 1518170323
  Care Compare group
• The Cleveland Clinic Foundation

  • Eyewear Supplier
  • Independence, OH
  • NPI 1619551025
  Care Compare group
• The Cleveland Clinic Foundation

  • Optometrist
  • Loudonville, OH
  • NPI 1649441783
  Care Compare group

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

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1235672437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 LINCOLN DR",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302137",
            "telephone_number": "440-813-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 LINCOLN DR",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302137",
            "telephone_number": "440-813-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINONEN",
        "first_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004922RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Grubke
• Tammy Ruth Hagstrom
• Kimberly Hall
• Elbert Leland Hanna II, L.P.N
• Doris May Harper, R.N.
• Jessica N. Herd, LPN
• Albert Joseph Hoffman, O.D.
• Hanna Marie Hunt, MS,RD,LD
• Gary Robert Huston, DO
• Alissa Ianetta, PSYS

• All providers in Conneaut, OH
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.