Individual provider Active NPI

Jonathan Jason Van Heertum, D.O.

  • Emergency Medicine Physician
  • Naples, FL
National Provider Identifier
1639583594
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
UO3768 Issued in FL
Practice address
625 Tamiami TRL N Ste 304
Naples, FL 34102-8143
Phone
(239) 234-6829
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X UO3768 FL Primary

Addresses

Primary practice location

625 Tamiami TRL N Ste 304
Naples, FL 34102-8143

Mailing address

625 Tamiami TRL N Ste 304
Naples, FL 34102-8143
Phone (239) 234-6829

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150106001460 FL Practitioner - Emergency Medicine 2567785199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Emergency Medicine Specialists LLCGroup PAC ID 7517267628, 13 clinicians

Practice addresses (Care Compare)

8300 Collier Blvd
Naples, FL 34114-3549
Phone (239) 354-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO3768FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Dec 4, 2014 Accepting new patients
MD Now Medical Centers Inc CurrentSince Dec 4, 2014 Accepting new patients
Integrated Emergency Medicine Specialists LLC Emergency Medicine CurrentSince Oct 1, 2015 Accepting new patients

Locations

6300 N Andrews Ave
Ft Lauderdale, FL 33309
Phone (954) 492-2035

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

12555 Biscayne Blvd
North Miami, FL 33181
Phone (305) 379-4442

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

Organizations & group practices 3

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 2

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1639583594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 TAMIAMI TRL N STE 304",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341028143",
            "telephone_number": "239-234-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 TAMIAMI TRL N STE 304",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341028143",
            "telephone_number": "239-234-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HEERTUM",
        "first_name": "JONATHAN",
        "middle_name": "JASON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "UO3768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.