NPIMap

Individual provider Active NPI

Justin Heizer, M.D.

  • Interventional Cardiology Physician
  • Suffolk, VA
National Provider Identifier
1831503465
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
0101263422 Issued in VA
Practice address
2790 Godwin Blvd Ste 100
Suffolk, VA 23434-8151
Phone
(757) 983-8750
Fax
(757) 510-9442
NPI assigned
Jun 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0116030256 VA
Interventional Cardiology Physician 207RI0011X 0101263422 VA Primary

Addresses

Primary practice location

2790 Godwin Blvd Ste 100
Suffolk, VA 23434-8151

Mailing address

2790 Godwin Blvd Ste 100
Suffolk, VA 23434-8151
Phone (757) 983-8750

Other practice location 1

1250 E Marshall Street
PO Box 980053
Richmond, VA 23298
Phone (804) 828-9989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190425001972 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 1254553910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Eastern Virginia Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

2790 Godwin Blvd
Suite 205
Suffolk, VA 23434-8154
Phone (757) 934-7753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting95
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101263422VAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Cardiovascular Disease CurrentSince Aug 16, 2021 Accepting new patients
Vibra Physicians LLC CurrentSince Feb 9, 2019 Accepting new patients

Locations

5 E River Park Pl E
Ste 460
Fresno, CA 93720

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2220 Edward Holland Dr
Richmond, VA 23230
Phone (804) 678-7000

2790 Godwin Blvd
Ste 205
Suffolk, VA 23434
Phone (757) 934-7753

2790 Godwin Blvd
Ste 100
Suffolk, VA 23434
Phone (757) 252-9365

Interoperability endpoints

  • Direct secure messaging: jheizer681847@direct.sentara.net

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1831503465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-983-8750",
            "fax_number": "757-510-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-983-8750",
            "fax_number": "757-510-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall Street",
            "address_2": "PO Box 980053",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "23298",
            "country_code": "US",
            "telephone_number": "804-828-9989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIZER",
        "first_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0116030256",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101263422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.