Ryan Daniel Heinz, DC
Individual provider Active NPI Chiropractor · Lodi, NJ
NPI 1366938748 · NPPES record last updated Jun 22, 2020
Key facts
- NPI
- 1366938748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH12963 (FL)
- Practice address
- 1 S Main St Ste 1
Lodi, NJ 07644-2235 - Phone
- (973) 472-7465
- NPI assigned
- Jul 9, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
360 Town Plaza Ave
Suite 330
Ponte Vedra, FL 32081-5175
Phone (904) 210-5313
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200414003014 | FL | Practitioner - Chiropractic | 8426307117 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Institute of North Jersey | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH12963 | FL | Yes |
Addresses
Primary practice location
1 S Main St Ste 1
Lodi, NJ 07644-2235
Mailing address
44 Weston Cir
Ponte Vedra, FL 32081-0650
Phone (904) 210-5313
Other providers in Lodi, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.