Individual provider Active NPI

Chana Heintz, MD

  • Pediatrics Physician
  • Zachary, LA
National Provider Identifier
1366002180
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
333683 Issued in LA
Practice address
6110 Main St Ste B
Zachary, LA 70791-4079
Phone
(225) 658-4070
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 333683 LA Primary

Addresses

Primary practice location

6110 Main St Ste B
Zachary, LA 70791-4079

Mailing address

1001 Main St
Buffalo, NY 14203-1009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241204004220 NY Practitioner - Pediatric Medicine 5496082711 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333435NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aizer Health , Inc. CurrentSince Oct 1, 2024 Accepting new patients
Aizer Health , Inc. CurrentSince Oct 1, 2024 Accepting new patients
Hospital Service District 1 of East Baton Rouge Parish Pediatrics Past Accepting new patients

Locations

49 Forest Rd
Monroe, NY 10950
Phone (845) 782-3242

Organizations & group practices 3

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1366002180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MAIN ST STE B",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914079",
            "telephone_number": "225-658-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZ",
        "first_name": "CHANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "333683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.