Edwin Heidelberger, MD PHD
Individual provider Active NPI Internal Medicine Physician · Springville, NY
NPI 1821070970 · NPPES record last updated Mar 13, 2008
Key facts
- NPI
- 1821070970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 190805 (NY)
- Practice address
- 210 E Main St
Springville, NY 14141-1442 - Phone
- (716) 592-3635
- Fax
- (716) 592-2929
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- State University of New York at Buffalo School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bertrand Chaffee Hospital
Practice addresses (Care Compare)
224 E Main St
Springville, NY 14141-1443
Phone 71659228711202
Hospital & facility affiliations
- Vna of Western Ny Chha
- Bertrand Chaffee Hospital
- Olean General Hospital
- Mercy Hospital of Buffalo
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090105000201 | NY | Practitioner - Internal Medicine |
5991728768 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bertrand Chaffee Hospital | Current |
Accepting new patients | |
| County of Erie Comptrollers Office | Past | Accepting new patients | |
| Concord Medical Group PC | Past | Accepting new patients |
Locations
224 E Main St
Springville, NY 14141
Phone (716) 592-2871
210 E Main St
Springville, NY 14141
Phone (716) 592-3600
Interoperability endpoints
- https://fhir.yourcareuniverse.net/tenant/a7b918c3-56d9-410c-bec6-e3d86fde3f92
- edwin_heidelberger@yourcarecommunity.org
- edwin.heidelberger@bch.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 190805 | NY | Yes |
| Pediatrics Physician | 208000000X | 190805 | NY |
Addresses
Primary practice location
210 E Main St
Springville, NY 14141-1442
Mailing address
210 E Main St
Springville, NY 14141-1442
Phone (716) 592-3635
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 190805 | Other | NY | WORKERS COMP |
| 00020006701 | Other | NY | UNIVERA |
| 0145550001 | Other | NY | DMERC |
| 01458795 | Medicaid | NY | |
| 0003153 | Other | NY | GHI |
| 0408931AOA | Other | NY | INDEPENDENT HEALTH |
| 000523119009 | Other | NY | BCBS |
Other providers in Springville, NY
- Melissa Emily Hake
- Robbin H Hansen
- Hart Associates of Springville, Inc.
- Patricia Ann Hayes
- Kathleen Marie Hebdon
- Meaghan Heighway
- Heim Therapy Associates
- Amy R Hernquist
- Valentine Hill
- Giang Hoang
All providers in Springville, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.