NPIMap

Individual provider Active NPI

Mark Stephen Heine, PA-C

  • Physician Assistant
  • Spearfish, SD
National Provider Identifier
1366489403
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0450 Issued in SD
Practice address
2479 E Colorado Blvd
Spearfish, SD 57783-3204
Phone
(605) 644-4460
Fax
(605) 644-4461
NPI assigned
May 31, 2006
Last updated
Feb 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0450 SD Primary

Addresses

Primary practice location

2479 E Colorado Blvd
Spearfish, SD 57783-3204

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090113000841 SD Practitioner - Physician Assistant 5193888428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

1440 N Main St
Spearfish, SD 57783-1505
Phone (605) 644-4000

2479 E Colorado Blvd
Spearfish, SD 57783-3204
Phone (605) 644-4460

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 16, 2009 Accepting new patients
Avera McKennan Physician Assistant CurrentSince Oct 16, 2009 Accepting new patients
Monument Health Network, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Monument Health Network, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Regional Health Physicians Inc Past Accepting new patients
Orthopedic Institute PC Past Accepting new patients
Affordable Medical Care LLC Physician Assistant Past Accepting new patients

Locations

61 Charles St
Deadwood, SD 57732
Phone (605) 717-6000

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

3000 S Minnesota Ave
Sioux Falls, SD 57105
Phone (605) 332-1502

810 E 23rd St
Sioux Falls, SD 57105
Phone (605) 339-6823

1316 N 10th St
Spearfish, SD 57783
Phone (605) 642-3113

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

2479 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 644-4460

Interoperability endpoints

  • Direct secure messaging: mheine.8300@regionalhealth.sdhealthlink.net

Organizations & group practices 9

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 12

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1366489403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 E COLORADO BLVD",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833204",
            "telephone_number": "605-644-4460",
            "fax_number": "605-644-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINE",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.