Michael Heder, DO
Individual provider Active NPI Family Medicine Physician · Heber, UT
NPI 1629563572 · NPPES record last updated Jul 27, 2021
Key facts
- NPI
- 1629563572
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 12292652-1204 (UT)
- Practice address
- 1300 S US-89
Heber, UT 84032 - Phone
- (435) 657-8000
- Fax
- (435) 657-8001
- NPI assigned
- Jun 23, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Revere Health PC
Practice addresses (Care Compare)
1300 S US
Suite 189
Heber, UT 84032
Phone (435) 657-8000
Hospital & facility affiliations
- Enhabit Home Health
- Intermountain Health Heber Valley Hospital
- Park City Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 21 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210712002893 | UT | Practitioner - Family Practice | 1153723218 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients |
Locations
1300 S Highway 189
Heber City, UT 84032
Phone (435) 657-8000
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
Interoperability endpoints
- michaelheder@cuccu.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IL | ||
| Family Medicine Physician | 207Q00000X | 12292652-1204 | UT | Yes |
Addresses
Primary practice location
1300 S US-89
Heber, UT 84032
Mailing address
1150 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Other practice location 1
815 Main St Ste C
Peoria, IL 61602-1080
Phone (309) 672-4977
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | credentialing@reverehealth.com | Revere Health PC |
Other providers in Heber, UT
- Tod L Berg
- Kelly C Cook
- Nicole Davis
- Ron T Dummar
- Ihc Health Services, Inc
- Mountain Medical Family Therapy
- Ralph W Ogilvie
- Wasatch Medical Imaging LLC
- James Bruce Williams
All providers in Heber, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.