Individual provider Active NPI

Heidi C Calipjo, M.D.

  • Family Medicine Physician
  • Osage Beach, MO
National Provider Identifier
1720288236
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010024506 Issued in MO
Practice address
1057 Medical Park Dr
Suite a
Osage Beach, MO 65065-3000
Phone
(573) 302-3100
Fax
(573) 348-8279
NPI assigned
Jul 23, 2007
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125-052442 IL
Family Medicine Physician 207Q00000X 2010024506 MO Primary

Addresses

Primary practice location

1057 Medical Park Dr
Suite a
Osage Beach, MO 65065-3000

Mailing address

PO Box 1500
Osage Beach, MO 65065-1500

Other identifiers 4

IdentifierTypeStateIssuer
P00867670OtherMORAIL ROAD MEDICARE
135570025OtherMOMEDICARE PTAN
1720288236MedicaidMO
2010024506OtherMOMO LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100901000389 MO Practitioner - Family Practice 4981728623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

54 Hospital Dr
Osage Beach, MO 65065-3050

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-052442ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System Current Accepting new patients
Lake Regional Health System CurrentSince Apr 1, 2014 Accepting new patients
Lake Regional Health System Family Medicine CurrentSince Apr 1, 2014 Accepting new patients

Locations

304A E 4th St
Eldon, MO 65026
Phone (573) 392-5654

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049
Phone (573) 365-2318

1057 Medical Park Dr
Osage Beach, MO 65065
Phone (573) 302-3100

1057 Medical Park Dr
#A
Osage Beach, MO 65065
Phone (573) 302-3200

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Interoperability endpoints

  • Direct secure messaging: heidicalipjo@mhccaremail.com

Organizations & group practices 4

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 4

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1720288236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650651500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 MEDICAL PARK DR",
            "address_2": "SUITE A",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653000",
            "telephone_number": "573-302-3100",
            "fax_number": "573-348-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIPJO",
        "first_name": "HEIDI",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-052442",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010024506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00867670",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "135570025",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720288236",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2010024506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.