Active NPI
Robert Paul Heck, PH.D
- Psychologist
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2004-1203A
- Practice address
- 10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912 - Phone
- (260) 387-6340
- NPI assigned
- Nov 29, 2006
- Last updated
- Jan 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2004-1203A | IN | Primary |
| Psychologist | 103T00000X | 5386 | OH |
Addresses
Primary practice location
10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912
Mailing address
10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912
Phone (260) 387-6340
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200984000 | Other | IN | MAGELLAN BEHAVIORAL |
| 000-000-175-606 | Other | IN | BC-BS NON-PAR |
| 000-777-2138 | Other | IN | AETNA NON-PAR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- West Virginia University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1030 W Wayne St
Paulding, OH 45879-1545
Phone 2603876340105
10315 Dawsons Creek Blvd
Suite F
Ft Wayne, IN 46825-1912
10315 Dawsons Creek Blvd F
Fort Wayne, IN 46825-1912
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004-1203A | IN | MD | Psychologist |
| 5386 | OH | MD | Psychologist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1386711984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10315 DAWSONS CREEK BLVD",
"address_2": "SUITE F",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251912",
"telephone_number": "260-387-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10315 DAWSONS CREEK BLVD",
"address_2": "SUITE F",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251912",
"telephone_number": "260-387-6340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HECK",
"first_name": "ROBERT",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "2004-1203A",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5386",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL",
"identifier": "200984000",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC-BS NON-PAR",
"identifier": "000-000-175-606",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-PAR",
"identifier": "000-777-2138",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.