Individual provider Active NPI

Rebecca Carrie Heintzelman, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1437310349
Registry record updated Apr 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD439203 Issued in PA
Practice address
1331 E Wyoming Ave
Department of Pathology
Philadelphia, PA 19124-3808
Phone
(215) 537-6921
NPI assigned
Jun 23, 2008
Last updated
Apr 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD439203 PA Primary

Addresses

Primary practice location

1331 E Wyoming Ave
Department of Pathology
Philadelphia, PA 19124-3808

Mailing address

1331 E Wyoming Ave
Department of Pathology
Philadelphia, PA 19124-3808
Phone (215) 537-6921

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000094 PA Practitioner - Pathology 3971770165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Pathology Associates, PCGroup PAC ID 9830179381, 11 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Pathology Associates, PC CurrentSince Jul 5, 2023 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

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.

Hospital & facility affiliations 6

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618704000000",
    "number": "1437310349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-537-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-537-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZELMAN",
        "first_name": "REBECCA",
        "middle_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-04-18",
        "certification_date": "2021-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD439203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.