Individual provider Active NPI

Jeana Marie Heinz, P.A.

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1720042393
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101635 Issued in FL
Practice address
17345 SW 8TH St
Pembroke Pines, FL 33029-4210
Phone
(954) 732-1222
Fax
(954) 430-6140
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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 PA9101635 FL Primary

Addresses

Primary practice location

17345 SW 8TH St
Pembroke Pines, FL 33029-4210

Mailing address

17345 SW 8TH St
Pembroke Pines, FL 33029-4210
Phone (954) 732-1222

Other identifiers 1

IdentifierTypeStateIssuer
291405100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 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

Enrollment IDStateProvider typePAC IDDetails
I20101216000582 FL Practitioner - Physician Assistant 1254529316
I20250204002129 TN Practitioner - Physician Assistant 1254529316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ap of Nashville, LLCGroup PAC ID 7012206733, 20 clinicians

Practice addresses (Care Compare)

2000 Glen Echo Rd
Suite 111
Nashville, TN 37215-2857
Phone (615) 657-4800

Hospital & facility affiliations

  • Saint Thomas Hospital for Spinal Surgery Hospital, Nashville, TN, CCN 440218

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Practitioners, LLC Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1720042393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17345 SW 8TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294210",
            "telephone_number": "954-732-1222",
            "fax_number": "954-430-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17345 SW 8TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294210",
            "telephone_number": "954-732-1222",
            "fax_number": "954-430-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "JEANA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291405100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.