Individual provider Active NPI

John David Heintzman, MD

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1689690653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD25673 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-8573
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25673 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

1912 SE 43Rd Ave
Portland, OR 97215-3119

Other identifiers 1

IdentifierTypeStateIssuer
213614MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20061016000417 OR Practitioner - Family Practice 3870599798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Clackamas Office of County AuditorGroup PAC ID 9537065560, shared by 8 NPIs, 75 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

110 Beavercreek Rd
Oregon City, OR 97045-4307
Phone (503) 655-8471

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

4212 SE Division St
Suite 150
Portland, OR 97206-1681
Phone (503) 418-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
Oregon Health & Science University CurrentSince Jul 1, 2017 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
Oregon Health & Science University Current Accepting new patients
Oregon Health & Science University CurrentSince Jul 1, 2017 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

2241 Lloyd Ctr
Portland, OR 97232

3303 S Bond Ave
Ste 9
Portland, OR 97239
Phone (503) 494-7400

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

Interoperability endpoints

  • Direct secure messaging: jheintzmanmd10559@direct.ohsu.edu

Organizations & group practices 7

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 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689690653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 SE 43RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINTZMAN",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD25673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213614",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.