Individual provider Active NPI

Frederic Marc Heitzer, MD

  • Internal Medicine Physician
  • Freehold, NJ
National Provider Identifier
1750499034
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA04253000 Issued in NJ
Practice address
55 Schanck Road
Suite a-12
Freehold, NJ 07728-2963
Phone
(732) 577-5525
Fax
(732) 577-0045
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA04253000 NJ Primary

Addresses

Primary practice location

55 Schanck Road
Suite a-12
Freehold, NJ 07728-2963

Mailing address

55 Schanck Road
Suite a-12
Freehold, NJ 07728-2963
Phone (732) 577-5525

Other identifiers 1

IdentifierTypeStateIssuer
1429604MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041104000687 NJ Practitioner - Internal Medicine 6709849466 Practice locations: Freehold, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

55 Schanck Rd
Freehold, NJ 07728-2963
Phone (732) 577-5525

Hospital & facility affiliations

  • Hackensack Meridian at Home Monmouth County Home health agency, Neptune, NJ, CCN 317084
  • Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA04253000NJMDInternal Medicine Physician

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1750499034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SCHANCK ROAD",
            "address_2": "SUITE A-12",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282963",
            "telephone_number": "732-577-5525",
            "fax_number": "732-577-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SCHANCK ROAD",
            "address_2": "SUITE A-12",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282963",
            "telephone_number": "732-577-5525",
            "fax_number": "732-577-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZER",
        "first_name": "FREDERIC",
        "middle_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA04253000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1429604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.