Individual provider Active NPI

Melissa Marie Heins, PA

  • Surgical Physician Assistant
  • New Haven, CT
National Provider Identifier
1255564464
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
20 York Street
New Haven, CT 06511
Phone
(203) 688-2182
NPI assigned
Sep 3, 2009
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2309 CT
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

20 York Street
New Haven, CT 06511

Mailing address

237 Elm St
Old Saybrook, CT 06475-1119

Other practice location 1

12 Bokum Rd
Essex, CT 06426-1500
Phone (860) 767-0796

Other practice location 2

540 Saybrook Rd Ste 100
Middletown, CT 06457-4760
Phone (860) 358-2850

Other names 1

  • Melissa Marie Czako Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100105000321 CT Practitioner - Physician Assistant 2668512567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

14 Jones Hollow Rd
Suite 2
Marlborough, CT 06447-1448
Phone (860) 358-2850

28 Crescent St
Middletown, CT 06457-3654

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MHS Primary Care Inc. Physician Assistant CurrentSince Jul 9, 2018 Accepting new patients
MHS Primary Care, Inc Physician Assistant Past Accepting new patients

Locations

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

540 Saybrook Rd
Ste 100A
Middletown, CT 06457
Phone (860) 347-9377

540 Saybrook Rd
Ste 100B
Middletown, CT 06457
Phone (860) 347-6683

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1255564464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-688-2182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Bokum Rd",
            "address_purpose": "LOCATION",
            "city": "Essex",
            "state": "CT",
            "postal_code": "064261500",
            "country_code": "US",
            "telephone_number": "860-767-0796",
            "fax_number": "860-767-1146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 Saybrook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064574760",
            "country_code": "US",
            "telephone_number": "860-358-2850",
            "fax_number": "860-358-8698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINS",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "2309",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CZAKO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.