Individual provider Active NPI

Robert Jay Heller, MD

  • Surgery Physician
  • University Park, FL
National Provider Identifier
1497765580
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME33832 Issued in FL
Practice address
7308 Barclay CT
University Park, FL 34201-2340
Phone
(863) 272-4118
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 01061233A IN
Surgery Physician 208600000X ME33832 FL Primary

Addresses

Primary practice location

7308 Barclay CT
University Park, FL 34201-2340

Mailing address

7308 Barclay CT
University Park, FL 34201-2340
Phone (863) 272-4118

Other practice location 1

5731 Bee Ridge Rd
Sarasota, FL 34233-5056
Phone (941) 342-1100

Other practice location 2

12880 Commodity Pl
Tampa, FL 33626-3101
Phone (813) 343-5500 ext. 278

Other identifiers 2

IdentifierTypeStateIssuer
100270190CMedicaidIN
200529510MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061233AINMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bartow Hma Physician Management, LLC Surgery Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497765580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 BARCLAY CT",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012340",
            "telephone_number": "863-272-4118",
            "fax_number": "443-262-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BARCLAY CT",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012340",
            "telephone_number": "863-272-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5731 Bee Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342335056",
            "country_code": "US",
            "telephone_number": "941-342-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12880 Commodity Pl",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336263101",
            "country_code": "US",
            "telephone_number": "813-343-5500 x278",
            "fax_number": "813-343-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELLER",
        "first_name": "ROBERT",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IN",
            "license": "01061233A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME33832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270190C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200529510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.