Individual provider Active NPI

Dana Marie Heinlein

  • Family Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1770152852
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06210869 Issued in FL
Practice address
3441 SE Willoughby Blvd
Stuart, FL 34994-5060
Phone
(772) 221-4000
Fax
(772) 221-4902
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06210869 FL Primary

Addresses

Primary practice location

3441 SE Willoughby Blvd
Stuart, FL 34994-5060

Mailing address

1684 SW Harbour Isles Cir
Port Saint Lucie, FL 34986-3404
Phone (772) 631-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220622001299 FL Practitioner - Nurse Practitioner 1456730449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F06210869FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Mar 10, 2022 Accepting new patients
Florida Department of Health CurrentSince Mar 10, 2022 Accepting new patients

Locations

3441 SE Willoughby Blvd
Stuart, FL 34994
Phone (772) 221-4000

800 Clematis St
West Palm Beach, FL 33401
Phone (561) 837-5560

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1770152852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 SW HARBOUR ISLES CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863404",
            "telephone_number": "772-631-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945060",
            "telephone_number": "772-221-4000",
            "fax_number": "772-221-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINLEIN",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F06210869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.