NPIMap

Individual provider Active NPI

David J. Headen, M.D.

  • Internal Medicine Physician
  • Beachwood, OH
National Provider Identifier
1528160348
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35063970 Issued in OH
Practice address
3909 Orange PL Ste 2400
Beachwood, OH 44122-4468
Phone
(216) 464-1115
Fax
(216) 464-2930
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35063970 OH Primary

Addresses

Primary practice location

3909 Orange PL Ste 2400
Beachwood, OH 44122-4468

Mailing address

24701 Euclid Ave
Third Floor Billing Services
Euclid, OH 44117-1714
Phone (216) 464-1115

Other identifiers 1

IdentifierTypeStateIssuer
0971006MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address davidheaden@uhps.allscriptsdirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000024 OH Practitioner - Internal Medicine 1052334885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3909 Orange PL
Suite 2400
Beachwood, OH 44122-4468
Phone (216) 383-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35063970OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Internal Medicine CurrentSince May 11, 2010 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University Primary Care Practices Inc Internal Medicine Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

3909 Orange Pl
Ste 2400
Beachwood, OH 44122
Phone (216) 464-1115

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: dheaden36103@ehrdirect.uhhospitals.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1528160348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "THIRD FLOOR BILLING SERVICES",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "216-464-1115",
            "fax_number": "216-464-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 ORANGE PL STE 2400",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224468",
            "telephone_number": "216-464-1115",
            "fax_number": "216-464-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADEN",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35063970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0971006",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "davidheaden@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3909 Orange Pl Ste 2400",
            "city": "Beachwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441224468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.