Active NPI
David Heisig, MD
- Gastroenterology Physician
- Syracuse, NY
National Provider Identifier
1851305437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 164528
- Practice address
- 4870 Broad Rd
Suite 3Q
Syracuse, NY 13215-2206 - Phone
- (315) 492-5765
- Fax
- (315) 492-5123
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 164528 | NY | Primary |
Addresses
Primary practice location
4870 Broad Rd
Suite 3Q
Syracuse, NY 13215-2206
Mailing address
4870 Broad Rd
Suite 3Q
Syracuse, NY 13215-2206
Phone (315) 492-5765
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00978276 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101202000359 | NY | Practitioner - Gastroenterology | 5597951558 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in | Gastroenterology | Current | Accepting new patients |
| Department of Medicine Medical Service Group | Current | Accepting new patients | |
| Loretto Health and Rehabilitation Center | Past | Accepting new patients |
Locations
251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000
750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363
Interoperability endpoints
- dheisig@hiemail.healtheconnections.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Syracuse, NY
- NPI 1063468239
Gastroenterology, NY
-
- Hematology & Oncology Physician
- Homer, NY
- NPI 1205104262
-
- Skilled Nursing Facility
- Syracuse, NY
- NPI 1588650873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447977600000",
"number": "1851305437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4870 BROAD RD",
"address_2": "SUITE 3Q",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132152206",
"telephone_number": "315-492-5765",
"fax_number": "315-492-5123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4870 BROAD RD",
"address_2": "SUITE 3Q",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132152206",
"telephone_number": "315-492-5765",
"fax_number": "315-492-5123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISIG",
"first_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2015-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "164528",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00978276",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.