Individual provider Active NPI

Jason J. Heisler, D.O.

  • Orthopaedic Trauma Physician
  • Fort Wayne, IN
National Provider Identifier
1255453544
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
02003175A Issued in IN
Practice address
5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone
(260) 484-8551
Fax
(260) 482-5060
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 02003175A IN
Orthopaedic Surgery Physician 207X00000X 5101015382 MI
Orthopaedic Trauma Physician 207XX0801X 02003175A IN Primary

Addresses

Primary practice location

5050 N Clinton St
Fort Wayne, IN 46825-5886

Mailing address

5052 N Clinton St
Fort Wayne, IN 46825-5822
Phone (260) 484-8551

Other practice location 1

1500 Provident Dr Ste B
Warsaw, IN 46580-3297
Phone (574) 269-8301

Other practice location 2

11136 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 484-8551

Other practice location 3

7920 W Jefferson Blvd
Fort Wayne, IN 46804-4168
Phone (260) 484-8551

Other identifiers 3

IdentifierTypeStateIssuer
02003175AOtherININDIANA LICENSE
200882680MedicaidIN
P00651304OtherINRR MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071019000312 IN Practitioner - Orthopedic Surgery 4486681889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics Northeast PCGroup PAC ID 9234024878, 80 clinicians

Practice addresses (Care Compare)

11136 Parkview Circle Dr
Fort Wayne, IN 46845-1730
Phone (260) 484-8551

Hospital & facility affiliations

  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
  • Orthopaedic Hospital at Parkview North Hospital, Fort Wayne, IN, CCN 150167
  • Parkview Whitley Hospital Hospital, Columbia City, IN, CCN 150101
  • Parkview Huntington Hospital Hospital, Huntington, IN, CCN 150091
  • Parkview Noble Hospital Hospital, Kendallville, IN, CCN 150146

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
85.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement57
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Northeast PC Orthopaedic Surgery CurrentSince Jul 11, 2008 Accepting new patients
Orthopaedics Northeast PC CurrentSince Jul 11, 2008 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

11136 Parkview Circle Dr
Fort Wayne, IN 46845

7920 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2668

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

11130 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-6221

1500 Provident Dr
Ste B
Warsaw, IN 46580
Phone (574) 269-8301

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1255453544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Provident Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803297",
            "country_code": "US",
            "telephone_number": "574-269-8301",
            "fax_number": "574-269-8302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11136 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451730",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7920 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044168",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEISLER",
        "first_name": "JASON",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "02003175A",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101015382",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "IN",
            "license": "02003175A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "02003175A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200882680",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00651304",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.