Active NPI
Theodore Joseph Heinz II, PHARMD
- Pharmacist
- Shirley, NY
National Provider Identifier
1598414922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065924
- Practice address
- 863 Montauk Hwy
Shirley, NY 11967-2111 - Phone
- (631) 399-1352
- NPI assigned
- Mar 22, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 065924 | NY | Primary |
Addresses
Primary practice location
863 Montauk Hwy
Shirley, NY 11967-2111
Mailing address
863 Montauk Hwy
Shirley, NY 11967-2111
Phone (631) 399-1352
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 065924 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
863 Montauk Hwy
Shirley, NY 11967
Phone (631) 399-1352
Organizations & group practices 2
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.
-
- Pharmacy
- Shirley, NY
- NPI 1063719805
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1598414922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "863 MONTAUK HWY",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119672111",
"telephone_number": "631-399-1352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "863 MONTAUK HWY",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119672111",
"telephone_number": "631-399-1352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINZ",
"first_name": "THEODORE",
"middle_name": "JOSEPH",
"name_suffix": "II",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-22",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shirley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.