Individual provider Active NPI

Joshua J Heinecke, O.D.

  • Optometrist
  • Oconomowoc, WI
National Provider Identifier
1285072686
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
329735 Issued in WI
Practice address
1280 N Summit Ave
Oconomowoc, WI 53066-4459
Phone
(262) 567-3214
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 329735 WI Primary

Addresses

Primary practice location

1280 N Summit Ave
Oconomowoc, WI 53066-4459

Mailing address

11920 W Janesville Rd Apt 4a
Hales Corners, WI 53130-2372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131106000885 WI Practitioner - Optometry 1951536812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
329735WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
JH Eyecare LLC Optometrist Current Accepting new patients
Thomas K. Marsh, Odsc Optometrist CurrentSince Dec 1, 2014 Accepting new patients

Locations

1280 N Summit Ave
Summit, WI 53066
Phone (262) 567-3214

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1285072686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11920 W JANESVILLE RD APT 4A",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 N SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664459",
            "telephone_number": "262-567-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINECKE",
        "first_name": "JOSHUA",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "329735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.