Individual provider Active NPI

Michael J Heinz, MPT

  • Orthopedic Physical Therapist
  • Lee's Summit, MO
National Provider Identifier
1609984061
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2003020133 Issued in MO
Practice address
1535 NE Douglas St
Lees Summit, MO 64086-4611
Phone
(816) 347-1596
NPI assigned
Aug 27, 2006
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-03542 KS
Orthopedic Physical Therapist 2251X0800X 2003020133 MO Primary

Addresses

Primary practice location

1535 NE Douglas St
Lees Summit, MO 64086-4611

Mailing address

2817 NE Marywood LN
Lees Summit, MO 64086-7081
Phone (816) 645-3361

Other identifiers 1

IdentifierTypeStateIssuer
2003020133OtherMOLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140421001501 MO Practitioner - Physical Therapist in Private Practice 0749339109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Hand and Physical Therapy, LLCGroup PAC ID 0840737144, 3 clinicians

Practice addresses (Care Compare)

3730 NE Troon Dr
Suite a
Lees Summit, MO 64064-1988
Phone (816) 602-5046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-03542KSMDPhysical Therapist
2003020133MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Hand and Physical Therapy LLC Physical Therapist CurrentSince Jan 20, 2025 Accepting new patients

Locations

3730 NE Troon Dr
Ste A
Lees Summit, MO 64064
Phone (816) 602-5046

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1609984061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NE MARYWOOD LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640867081",
            "telephone_number": "816-645-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864611",
            "telephone_number": "816-347-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03542",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2003020133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "2003020133",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.