Individual provider Active NPI

Andrew Dunsmore Heinzelmann, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fayetteville, AR
National Provider Identifier
1548389455
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
E-4659 Issued in AR
Practice address
3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone
(479) 521-2752
Fax
(479) 444-6942
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X E-4659 AR
Orthopaedic Surgery Physician 207X00000X 19708 MS
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X E-4659 AR Primary

Addresses

Primary practice location

3317 N Wimberly Dr
Fayetteville, AR 72703-4056

Mailing address

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 587-3149

Other identifiers 3

IdentifierTypeStateIssuer
08070023900OtherARQUALCHOICE
5H114OtherARBLUE CROSS BLUE CHEILD
168677001MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20080514000278 AR Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 3274624390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)115
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Orthopaedics, PA Orthopaedic Surgery CurrentSince Jul 1, 2008 Accepting new patients
Ozark Orthopaedics, P.a. Orthopaedic Surgery CurrentSince Jul 1, 2008 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery Past Accepting new patients

Locations

3317 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-2752

3352 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 521-1427

Interoperability endpoints

  • Direct secure messaging: andrew.heinzelmann.1@18403.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4
  • Direct secure messaging: aheinzelmann23180@washingtonregional.direct-ci.com

Organizations & group practices 3

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 2

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1548389455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-587-3149",
            "fax_number": "479-521-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-444-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZELMANN",
        "first_name": "ANDREW",
        "middle_name": "DUNSMORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "E-4659",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "19708",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AR",
            "license": "E-4659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "08070023900",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE CHEILD",
            "identifier": "5H114",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168677001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.