NPIMap

Individual provider Active NPI

Heidie Elizabeth Nobles, PA

  • Physician Assistant
  • Horseheads, NY
National Provider Identifier
1639665037
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022135 Issued in NY
Practice address
100 John Roemmelt Dr FL 3
Horseheads, NY 14845-8301
Phone
(607) 739-0352
Fax
(607) 739-6909
NPI assigned
Jul 9, 2018
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022135 NY Primary

Addresses

Primary practice location

100 John Roemmelt Dr FL 3
Horseheads, NY 14845-8301

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other practice location 1

123 Conhocton St Ste 101
Corning, NY 14830-2959
Phone (607) 438-1200

Other identifiers 1

IdentifierTypeStateIssuer
022135OtherNYNYS LICENSE

Other names 1

  • Heidi Elizabeth Warren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180731002025 NY Practitioner - Physician Assistant 4789932294 Reassigns benefits to 6 organizations
I20220308000021 PA Practitioner - Physician Assistant 4789932294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Patient First Medical Practice PCGroup PAC ID 0042687006, 33 clinicians
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

1256 E 31St St
Brooklyn, NY 11210-4741
Phone (718) 534-0689

50 Sheffield Ave
Brooklyn, NY 11207-2420
Phone (718) 345-2273

7009 Rumsey St Ext
Bath, NY 14810-7827
Phone (607) 776-7651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022135NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JDS Medical Services PC CurrentSince Jan 18, 2026 Accepting new patients
Nes Medical Services of New York PC CurrentSince Oct 5, 2019 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Feb 14, 2022 Accepting new patients
Corning Hospital CurrentSince Dec 17, 2019 Accepting new patients

Locations

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1639665037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050",
            "fax_number": "607-271-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOHN ROEMMELT DR FL 3",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458301",
            "telephone_number": "607-739-0352",
            "fax_number": "607-739-6909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Conhocton St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148302959",
            "country_code": "US",
            "telephone_number": "607-438-1200",
            "fax_number": "607-438-1221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "HEIDIE",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "022135",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "WARREN",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.