NPIMap

Organization Active NPI

Heim Staff Physicians, Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Leesport, PA
National Provider Identifier
1831217314
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
HEIM STAFF PHYSICIANS, INC
Practice address
1011 Berk Rd
Leesport, PA 19533-8705
Phone
(610) 376-4841
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Dr. Robert Brackbill, MDNPI 1861498636
Title
President
Phone
(610) 378-9449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

1011 Berk Rd
Leesport, PA 19533-8705

Mailing address

602 Wyomissing Blvd
Wyomissing, PA 19610-2268
Phone (610) 678-1887

Other identifiers 2

IdentifierTypeStateIssuer
0009927090006MedicaidPA
0009927090009MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000434 PA Part B Supplier - Clinic/Group Practice 7719963826 Receives reassigned benefits from 5 practitioners
Practice locations: Leesport, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1831217314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 WYOMISSING BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102268",
            "telephone_number": "610-678-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BERK RD",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338705",
            "telephone_number": "610-376-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIM STAFF PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BRACKBILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-378-9449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009927090006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009927090009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.