Individual provider Active NPI

Kaylee Marie Heitz

  • Speech-Language Pathologist
  • Wausau, WI
National Provider Identifier
1629647441
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA23035 Issued in FL
Practice address
520 N 28TH Ave
Wausau, WI 54401-4101
Phone
(715) 843-1058
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X SA23035 FL Primary

Addresses

Primary practice location

520 N 28TH Ave
Wausau, WI 54401-4101

Mailing address

520 N 28TH Ave
Wausau, WI 54401-4101
Phone (715) 843-1058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MD, TX, FL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20210729000923 WI Practitioner - Qualified Speech Language Pathologist 1850794785 Reassigns benefits to 1 organization
I20240708002400 MD Practitioner - Qualified Speech Language Pathologist 1850794785 Reassigns benefits to 1 organization
I20241015001459 TX Practitioner - Qualified Speech Language Pathologist 1850794785 Reassigns benefits to 1 organization
I20241015003763 FL Practitioner - Qualified Speech Language Pathologist 1850794785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Expressable Speech-Language Pathology PCGroup PAC ID 4688074511, 115 clinicians
Expressable Therapy PCGroup PAC ID 0042698136, 67 clinicians

Practice addresses (Care Compare)

111 N Orange Ave
Suite 800
Orlando, FL 32801-2381
Phone (512) 399-0064

1997 Annapolis Exchange Pkwy
Suite 300
Annapolis, MD 21401-3273
Phone (561) 462-3933

342 N Water St
Suite 600
Milwaukee, WI 53202-5715
Phone (561) 462-3933

3800 N Lamar Blvd
Suite 200
Austin, TX 78756-0003
Phone (512) 377-6318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11140MDMDClinical Social Worker
SA23035FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Sep 27, 2024 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Jul 8, 2024 Accepting new patients

Locations

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

1997 Annapolis Exchange Pkwy
Ste 300
Annapolis, MD 21401
Phone (410) 261-6439

3800 N Lamar Blvd
Ste 200
Austin, TX 78756
Phone (303) 578-2702

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

204 E Cano St
Edinburg, TX 78539
Phone (956) 642-0828

363 N Sam Houston Pkwy E
Ste 1100
Houston, TX 77060
Phone (281) 809-7214

342 N Water St
Ste 600
Milwaukee, WI 53202
Phone (414) 296-6189

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1629647441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N 28TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014101",
            "telephone_number": "715-843-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 28TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014101",
            "telephone_number": "715-843-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZ",
        "first_name": "KAYLEE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA23035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.