Individual provider Active NPI

Susan Marie Heineck, M.D.

  • Internal Medicine Physician
  • Seguin, TX
National Provider Identifier
1245345610
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q7204 Issued in TX
Practice address
1215 E Court St
Seguin, TX 78155-5129
Phone
(830) 379-2411
NPI assigned
Aug 19, 2006
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD23510 OR
Emergency Medicine Physician 207P00000X Q7204 TX
Emergency Medicine Physician 207P00000X MD2016-0139 NM
Emergency Medicine Physician 207P00000X MD.34932 AL
Internal Medicine Physician 207R00000X Q7204 TX Primary

Addresses

Primary practice location

1215 E Court St
Seguin, TX 78155-5129

Mailing address

20108 Victoria Chase Rd
Lago Vista, TX 78645-6311
Phone (503) 507-8701

Other identifiers 1

IdentifierTypeStateIssuer
287063MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160510000968 TX Practitioner - Internal MedicinePractitioner - Emergency Medicine 0840186490 Reassigns benefits to 2 organizations
I20160524001080 NM Practitioner - Internal Medicine 0840186490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.34932ALMDEmergency Medicine Physician
Q7204TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alteon Health New Mexico LLC Emergency Medicine CurrentSince Apr 17, 2016 Accepting new patients
Hospitalist Medicine Physicians of New Mexico - Clovis, LLC Emergency Medicine CurrentSince Nov 8, 2022 Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Oct 3, 2022 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Oct 3, 2022 Accepting new patients
Columbia Lutheran Charities Family Medicine Past Accepting new patients
Asante Community Services LLC Past Accepting new patients
Brazos Medical Associates Family Medicine Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

4900 N Lovington Hwy
Hobbs, NM 88240
Phone (575) 492-5000

5419 N Lovington Hwy
Hobbs, NM 88240
Phone (505) 492-5000

405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

Organizations & group practices 8

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1245345610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20108 VICTORIA CHASE RD",
            "city": "LAGO VISTA",
            "state": "TX",
            "postal_code": "786456311",
            "telephone_number": "503-507-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E COURT ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555129",
            "telephone_number": "830-379-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINECK",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD23510",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q7204",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2016-0139",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.34932",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q7204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287063",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

Verify at the official NPI Registry.