Theodore Raymond Heim, D.O.
Individual provider Active NPI Emergency Medicine Physician · Pontiac, MI
NPI 1396974523 · NPPES record last updated Jul 9, 2009
Key facts
- NPI
- 1396974523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5101018285 (MI)
- Practice address
- 50 N Perry St
Pontiac, MI 48342-2217 - Phone
- (248) 338-5392
- Fax
- (248) 338-5567
- NPI assigned
- Jul 9, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS PHS Naihs Crownpoint Hospital
Practice addresses (Care Compare)
Junction of Hwy 371 Navajo RT 9
Crownpoint, NM 87313-0358
Phone (505) 786-5291
Hospital & facility affiliations
- Crownpoint Healthcare Facility
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260130002344 | TX | Practitioner - Emergency Medicine | 5092958082 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101018285 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thoreau Clinic | Current |
Accepting new patients | |
| DHHS PHS Naihs Crownpoint Hospital | Current |
Accepting new patients | |
| Pueblo Pintado Clinic | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101018285 | MI | Yes |
Addresses
Primary practice location
50 N Perry St
Pontiac, MI 48342-2217
Mailing address
50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5392
Other providers in Pontiac, MI
- Crystal Marie Heath
- Heaven Keys, Inc
- Bethany Hebron
- Lauren Hecht
- Kathryn Heifferon
- Karla Heinig
- Samantha Helmke
- Helping Hands Medical Supplies & Equipment, LLC
- Nikhil Hemady
- R Steven Hemby
All providers in Pontiac, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2009. 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.
- Order and Referring (CMS).
- 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.