Active NPI
Mark Steven Heffron, D.C.
- Radiology Chiropractor
- Queens Village, NY
National Provider Identifier
1629153036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Chiropractor
- License
- X002652
- Practice address
- 8003 211TH St
Queens Village, NY 11427-1012 - Phone
- (718) 464-8948
- Fax
- (718) 740-0319
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiology Chiropractor | 111NR0200X | X002652 | NY | Primary |
Addresses
Primary practice location
8003 211TH St
Queens Village, NY 11427-1012
Mailing address
8003 211TH St
Queens Village, NY 11427-1012
Phone (718) 464-8948
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-2847332 | Other | NY | TAX ID |
| 0079854 | Other | NY | GHI PROVIDER NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X002652 | NY | MD | Radiology Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heffron Chiropractic Office | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Hollis Hills, NY
- NPI 1285013862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1629153036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8003 211TH ST",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114271012",
"telephone_number": "718-464-8948",
"fax_number": "718-740-0319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8003 211TH ST",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114271012",
"telephone_number": "718-464-8948",
"fax_number": "718-740-0319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEFFRON",
"first_name": "MARK",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0200X",
"taxonomy_group": "",
"desc": "Chiropractor, Radiology",
"state": "NY",
"license": "X002652",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "11-2847332",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER NUMBER",
"identifier": "0079854",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.