Elyssa Kleinwaks Heisey

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS025549 Issued in PA

Practice address

1991 Sproul Rd Ste 140
Broomall, PA 19008-3518

Phone

(610) 325-0309

NPI assigned

Mar 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Family Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1790487254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD STE 140",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083518",
            "telephone_number": "610-325-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD STE 140",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083518",
            "telephone_number": "610-325-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEY",
        "first_name": "ELYSSA",
        "middle_name": "KLEINWAKS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS025549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Hearn, LPC
• Ella Hecht
• Dana Elizabeth Heilman, COTA/L
• Amanda Mary Heilmann, BEHAVIOR TECHNICIAN
• Randolph P. Heinzel, MD
• Laurie Hernandez, BEHAVIOR TECHNICIAN
• Grace Herron, RN
• Rachael Hesse
• Matthew B Hillis, M.D.
• Megan Hiltebeitel, LCSW

• Family Medicine Physician in Broomall, PA
• Providers in Broomall, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.