Individual provider Active NPI

Heather Elizabeth Heim-Boedecker, DC

  • Chiropractor
  • Buffalo, NY
National Provider Identifier
1689282543
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X013337-01 Issued in NY
Practice address
295 Main St RM 1095
Buffalo, NY 14203-2512
Phone
(716) 513-6349
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X013337-01 NY Primary

Addresses

Primary practice location

295 Main St RM 1095
Buffalo, NY 14203-2512

Mailing address

483 79TH St
Niagara Falls, NY 14304-3301
Phone (716) 381-2614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201125000739 NY Practitioner - Chiropractic 7214348192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam Bowman DC PCGroup PAC ID 6608198585, 3 clinicians

Practice addresses (Care Compare)

3868 E Robinson Rd
Amherst, NY 14228-2001
Phone (716) 564-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X013337-01NYMDChiropractor
013337NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Bowman D.C., P.C. Chiropractor CurrentSince Oct 9, 2020 Accepting new patients
Grand Island Chiropractic PC Chiropractor PastSince Oct 9, 2020 Accepting new patients

Locations

3868 E Robinson Rd
West Amherst, NY 14228
Phone (716) 564-2225

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1689282543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 79TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143043301",
            "telephone_number": "716-381-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MAIN ST RM 1095",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032512",
            "telephone_number": "716-513-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM-BOEDECKER",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X013337-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.