NPIMap

Individual provider Active NPI

Teresa Carol Heatly, MD

  • Pulmonary Disease Physician
  • Mesa, AZ
National Provider Identifier
1366466039
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
23465 Issued in AZ
Practice address
5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346
Phone
(480) 290-7000
Fax
(480) 325-3461
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23465 AZ
Internal Medicine Physician 207R00000X 3600-320 WI
Pulmonary Disease Physician 207RP1001X 23465 AZ Primary
Pulmonary Disease Physician 207RP1001X 3600-320 WI

Addresses

Primary practice location

5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346

Mailing address

5151 E Broadway Rd Ste 107
Mesa, AZ 85206-1346
Phone (480) 290-7000

Other practice location 1

2550 W Union Hills Dr Ste 390
Phoenix, AZ 85027-5197
Phone (602) 443-4068

Other practice location 2

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

Other identifiers 2

IdentifierTypeStateIssuer
100258873MedicaidWI
318677MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theatly407287@ewd.direct.hshs.org Direct St Vincent Hospital-Hospital Sisters-Third Order of St Francis

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100309000807 AZ Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 7214072644 Reassigns benefits to 1 organization
I20240123002116 WI Practitioner - Pulmonary Disease 7214072644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, 593 clinicians
Pulmonary Associates PAGroup PAC ID 6406842558, 16 clinicians

Practice addresses (Care Compare)

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

2550 W Union Hills Dr
Suite 390
Phoenix, AZ 85027-5197
Phone (602) 443-4068

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3600-320WIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Pulmonary Associates, PA Pulmonary Disease CurrentSince Jan 3, 2010 Accepting new patients

Locations

5750 W Thunderbird Rd
Bldg E
Glendale, AZ 85306
Phone (602) 298-1932

5750 W Thunderbird Rd
Ste E500
Glendale, AZ 85306
Phone (602) 938-6960

5151 E Broadway Rd
Ste 107
Mesa, AZ 85206
Phone (480) 290-7000

3811 E Bell Rd
Ste 107
Phoenix, AZ 85032
Phone (602) 340-1689

9225 N 3rd St
Ste 205
Phoenix, AZ 85020
Phone (480) 867-7223

1112 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 258-4951

2550 W Union Hills Dr
Ste 390
Phoenix, AZ 85027
Phone (602) 443-4068

19841 N 27th Ave
Ste 102
Phoenix, AZ 85027
Phone (602) 258-4951

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: teresa.heatly.1@19484.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19484/brand/1/csg/1/fhir/r4

Organizations & group practices 18

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.

View all 18

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1366466039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061346",
            "telephone_number": "480-290-7000",
            "fax_number": "602-254-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 E BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061346",
            "telephone_number": "480-290-7000",
            "fax_number": "480-325-3461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 W Union Hills Dr Ste 390",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850275197",
            "country_code": "US",
            "telephone_number": "602-443-4068",
            "fax_number": "623-434-8310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1821 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543012253",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEATLY",
        "first_name": "TERESA",
        "middle_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "23465",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "3600-320",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "23465",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "3600-320",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100258873",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318677",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theatly407287@ewd.direct.hshs.org",
            "affiliation": "Y",
            "affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1821 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.