Thomas J Heinisch, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017088 Issued in NY

Practice address

107 Montrose Dr
Port Jefferson Station, NY 11776-1319

Phone

(631) 487-0083

NPI assigned

Oct 2, 2013

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Frank S Segreto MD PC

  • Orthopaedic Surgery Physician
  • Ronkonkoma, NY
  • NPI 1205170123
  Medicare reassignment
• Port Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Port Jefferson, NY
  • NPI 1912988395
  Medicare reassignment
• Island Medical Empire State, PLLC

  • Emergency Medicine Physician
  • Oneonta, NY
  • NPI 1053623041

  Physician Assistant

  NPD (past)
• Island Medical House Doctor PC

  • Family Medicine Physician
  • Hauppauge, NY
  • NPI 1477704005
  NPD (past)

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1386071587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MONTROSE DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761319",
            "telephone_number": "631-487-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MONTROSE DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761319",
            "telephone_number": "631-487-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINISCH",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Haug, NP
• Haven Medical Services, PLC
• Healing Points Acupuncture PC
• Nancy Heeman
• Leah T Hehn
• Robert Charles Hendler
• Diane Hendriks, LPN
• Heather Henkell, PHD
• Tamara Henry
• John Alexander Hermann

• Physician Assistant in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.