Individual provider Active NPI

Preston C Heath, PA

  • Physician Assistant
  • New Albany, OH
National Provider Identifier
1619605649
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004496A Issued in IN
Practice address
7277 Smiths Mill Rd Ste 200
New Albany, OH 43054-8195
Phone
(614) 221-6331
Fax
(614) 221-9042
NPI assigned
Aug 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 50.007727RX OH
Physician Assistant 363A00000X 10004496A IN Primary

Addresses

Primary practice location

7277 Smiths Mill Rd Ste 200
New Albany, OH 43054-8195

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

100 Navarre Pl Ste 4440
South Bend, IN 46601-1171
Phone (574) 647-5300

Other identifiers 1

IdentifierTypeStateIssuer
0000961MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221007001790 OH Practitioner - Physician Assistant 4789060120
I20241003000268 IN Practitioner - Physician Assistant 4789060120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

615 N Michigan St
South Bend, IN 46601-1033

615 N Michigan St FL
South Bend, IN 46601-1033

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Inc CurrentSince Oct 6, 2024 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Oct 6, 2024 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

3221 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-1670

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

100 Navarre Pl
Ste 4440
South Bend, IN 46601
Phone (574) 647-4540

Interoperability endpoints

  • Direct secure messaging: preston.heath.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 4

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 5

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": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1619605649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7277 SMITHS MILL RD STE 200",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548195",
            "telephone_number": "614-221-6331",
            "fax_number": "614-221-9042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Navarre Pl Ste 4440",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011171",
            "country_code": "US",
            "telephone_number": "574-647-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEATH",
        "first_name": "PRESTON",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007727RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004496A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000961",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, OH

Sources for this page

Verify at the official NPI Registry.