Derek B Heiser, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30517 Issued in FL

Practice address

5393 Roosevelt Blvd Ste 17
Jacksonville, FL 32210-8424

Phone

(904) 389-8570

Fax

(904) 389-8599

NPI assigned

May 21, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Orthopaedic Institute IncGroup PAC ID 5193625499, 60 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.01 of 100Reported as group

Improvement activities

40

Cost

74.03

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jacksonville Orthopaedic Institute Inc

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1346298023

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1205984762
  NPD (past)
• Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • Jacksonville Beach, FL
  • NPI 1902954332
  NPD (past)

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1558740720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687345",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5393 ROOSEVELT BLVD STE 17",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108424",
            "telephone_number": "904-389-8570",
            "fax_number": "904-389-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISER",
        "first_name": "DEREK",
        "middle_name": "B",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30517",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chet T. Hein, LMHC
• Erik Edward Heine, DO
• Kristen Elizabeth Heiner, PHARMF
• Joshua Heines
• William Heinrich Jr., DPM
• Lauren Campbell Heiser, PT, DPT
• Shelby Heiser
• Tori Lauren Heisse, LCSW
• Reza Hejazi, M.D.
• Helans Hope and Healing Counseling

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.