Individual provider Active NPI

Stacy Heimburger, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1598922007
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD203309 Issued in LA
Practice address
1430 Tulane Ave SL -50
New Orleans, LA 70112
Phone
(504) 988-7809
Fax
(504) 988-3971
NPI assigned
May 21, 2008
Last updated
Feb 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X FH2344593 LA
Internal Medicine Physician 207R00000X MD203309 LA Primary

Addresses

Primary practice location

1430 Tulane Ave SL -50
New Orleans, LA 70112

Mailing address

1430 Tulane Ave SL -50
New Orleans, LA 70112
Phone (504) 988-7809

Other identifiers 1

IdentifierTypeStateIssuer
1002593MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110125000657 LA Practitioner - Internal MedicinePractitioner - Emergency Medicine 0547449472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Tulane University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Service District 2 of the Parish of Tangipahoa State of laGroup PAC ID 2163314949, shared by 4 NPIs, 13 clinicians

Practice addresses (Care Compare)

301 Walnut St
Amite, LA 70422-2025
Phone (985) 748-9485

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD203309LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District 2 of the Parish of Tangipahoa State of la. Current Accepting new patients
Hospital Service District 2 of the Parish of Tangipahoa State of la. Emergency Medicine CurrentSince Apr 25, 2019 Accepting new patients
Hospital Service District 2 of the Parish of Tangipahoa State of la. CurrentSince Apr 25, 2019 Accepting new patients

Locations

301 Walnut St
Amite, LA 70422
Phone (985) 748-7141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1598922007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE SL -50",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-7809",
            "fax_number": "504-988-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE SL -50",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-7809",
            "fax_number": "504-988-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMBURGER",
        "first_name": "STACY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "FH2344593",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD203309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002593",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.