Individual provider Active NPI

Michael William Heaslet, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Irvine, CA
National Provider Identifier
1790735397
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E2056 Issued in CA
Practice address
4950 Barranca Pkwy
Suite 308
Irvine, CA 92604-4671
Phone
(949) 651-1202
Fax
(949) 552-9493
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E2056 CA Primary

Addresses

Primary practice location

4950 Barranca Pkwy
Suite 308
Irvine, CA 92604-4671

Mailing address

4950 Barranca Pkwy
Suite 308
Irvine, CA 92604-4671
Phone (949) 651-1202

Other identifiers 2

IdentifierTypeStateIssuer
95-3539063OtherCAFEDERAL TAX ID
E2056OtherCASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2056CAMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1790735397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 BARRANCA PKWY",
            "address_2": "SUITE 308",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044671",
            "telephone_number": "949-651-1202",
            "fax_number": "949-552-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 BARRANCA PKWY",
            "address_2": "SUITE 308",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044671",
            "telephone_number": "949-651-1202",
            "fax_number": "949-552-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEASLET",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "95-3539063",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "E2056",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.