NPIMap

Individual provider Active NPI

Thomas James Heinitz, M.D.

  • Family Medicine Physician
  • Proctor, MN
National Provider Identifier
1629022397
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41634 Issued in MN
Practice address
211 S Boundary Ave
Essentia Health Proctor Clinic
Proctor, MN 55810-2306
Phone
(218) 576-0200
Fax
(218) 624-7323
NPI assigned
May 19, 2006
Last updated
Dec 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41634 MN Primary

Addresses

Primary practice location

211 S Boundary Ave
Essentia Health Proctor Clinic
Proctor, MN 55810-2306

Mailing address

211 S Boundary Ave
Essentia Health Proctor Clinic
Proctor, MN 55810-2306
Phone (218) 576-0200

Other identifiers 3

IdentifierTypeStateIssuer
1629022397MedicaidMI
1629022397MedicaidMN
1629022397MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000297 MN Practitioner - Family Practice 7416962923 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Duluth Graduate Medical Education Council IncGroup PAC ID 4385545953, 32 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41634MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2016 Accepting new patients
Essentia Health Moose Lake Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Apr 2, 2016 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 2, 2016 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2016 Accepting new patients
St Marys Medical Center CurrentSince Mar 1, 2020 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary's Medical Center CurrentSince Mar 1, 2020 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Duluth Graduate Medical Education Council Inc Family Medicine CurrentSince Mar 1, 2016 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients
Essentia Health Virginia LLC Past Accepting new patients
Firstsolutions Past Accepting new patients
Residential Services of NE MN Inc. PastSince Sep 17, 2023 Accepting new patients

Locations

600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

1502 London Rd
Ste 102
Duluth, MN 55812
Phone (218) 576-0100

324 W Superior St
Ste 302
Duluth, MN 55802
Phone (218) 722-6613

330 N 8th Ave E
Duluth, MN 55805
Phone (218) 529-9122

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

211 S Boundary Ave
Proctor, MN 55810
Phone (218) 624-4818

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 10

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1629022397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S BOUNDARY AVE",
            "address_2": "ESSENTIA HEALTH PROCTOR CLINIC",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102306",
            "telephone_number": "218-576-0200",
            "fax_number": "218-624-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S BOUNDARY AVE",
            "address_2": "ESSENTIA HEALTH PROCTOR CLINIC",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102306",
            "telephone_number": "218-576-0200",
            "fax_number": "218-624-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINITZ",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629022397",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629022397",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629022397",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Proctor, MN

Sources for this page

Verify at the official NPI Registry.