Jack William Heidenreich, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD.020478 Issued in LA

Practice address

111 Acadia Drive
Raceland, LA 70394-2619

Phone

(985) 537-7575

Fax

(985) 537-7584

NPI assigned

Jul 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Family Practice

Education

Louisiana State University School of Medicine in Shreveport, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Home Health of Raceland Home health agency, Raceland, LA, CCN 197119
• Ochsner St Anne General Hospital Hospital, Raceland, LA, CCN 191324
• Ochsner St Mary Hospital, Morgan City, LA, CCN 190014
• Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
• Leonard J Chabert Medical Center Hospital, Houma, LA, CCN 190183
• Terrebonne General Medical Center - Parish Hospital, Houma, LA, CCN 190008

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jheidenreich12212@direct.ochsner.org

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.

• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment Care Compare group NPD
• Ochsner Bayou LLC

  • Critical Access Hospital
  • Raceland, LA
  • NPI 1396761805
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • Hammond, LA
  • NPI 1992904932
  NPD
• Cardiovascular Institute of the South, Apmc

  • Prosthetic/Orthotic Supplier
  • Raceland, LA
  • NPI 1477734424
  NPD (past)
• Cardiovascular Institute of the South, LLC

  • Cardiovascular Disease Physician
  • Houma, LA
  • NPI 1982689113

  Family Medicine

  NPD (past)

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

• Louisiana Homecare of Raceland, LLC

  • Home Health Agency
  • Raceland, LA
  • NPI 1356588024
  Care Compare affiliation
• Ochsner Bayou LLC

  • Critical Access Hospital
  • Raceland, LA
  • NPI 1396761805
  Care Compare affiliation
• Ochsner Clinic Foundation

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1811973100
  Care Compare affiliation
• Ochsner Morgan City LLC

  • General Acute Care Hospital
  • Morgan City, LA
  • NPI 1205482023
  Care Compare affiliation
• Southern Regional Medical Corporation

  • General Acute Care Hospital
  • Houma, LA
  • NPI 1326485749
  Care Compare affiliation
• Terrebonne Parish Hospital Service District #1

  • General Acute Care Hospital
  • Houma, LA
  • NPI 1518924109
  Care Compare affiliation

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1316944374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ACADIA DRIVE",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942619",
            "telephone_number": "985-537-7575",
            "fax_number": "985-537-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ACADIA DRIVE",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942619",
            "telephone_number": "985-537-7575",
            "fax_number": "985-537-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDENREICH",
        "first_name": "JACK",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.020478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1901407",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02635262",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080192843",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis J. Guillot
• Joyce Marie Hadley
• Mounkaila Garba Hamza, DPT
• Kakeisha Harris
• Megan Matherne Hartman, M.D.
• Ashley Henry, PHARMD
• Brett Michael Hernandez, PT, DPT
• Kenneth D Hoppens, M.D.
• Kyle O Hotard
• Jamie Bourgeois Huddleston, M.D.

• Family Medicine Physician in Raceland, LA
• Providers in Raceland, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.