Christopher K Heideman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1505 Issued in NV

Practice address

888 S Rancho Dr
Las Vegas, NV 89106-3810

Phone

(702) 740-4789

Fax

(702) 704-8394

NPI assigned

Feb 19, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NV, HI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: cheideman120913@westdirect.optum.com

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.

• Optum Medical Group II Rhodes P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment Care Compare group
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment
• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1659796274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-740-4789",
            "fax_number": "702-704-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-740-4789",
            "fax_number": "702-704-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEMAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA BOARD OF LICENSE # CS21714",
            "identifier": "CS21714",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA BORAD OF MEDICINE",
            "identifier": "PA1505",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA BORAD OF PHARMACY, #02087",
            "identifier": "02087",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lamonica Hefner
• Katelyn Hegarty, OTR/L
• Krista Hege
• Leslie Hegner
• Morgan Heidel, FNP
• Gregory Heideman, D.M.D.
• Heidi Sue Unger
• William Joseph Heidman, MD
• Ginnie Heidt
• Lynona Heidt

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.