Individual provider Active NPI

Donna Kathreen Heitzman, D.C.

  • Chiropractor
  • Provincetown, MA
National Provider Identifier
1861556813
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3539 Issued in NY
Practice address
241 Commercial St
Whalers Wharf
Provincetown, MA 02657-2102
Phone
(508) 487-3799
Fax
(508) 487-3799
NPI assigned
Dec 21, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3539 NY Primary
Chiropractor 111N00000X 770 MA

Addresses

Primary practice location

241 Commercial St
Whalers Wharf
Provincetown, MA 02657-2102

Mailing address

160 Kenwood Ave
Syracuse, NY 13208
Phone (315) 663-1939

Other identifiers 1

IdentifierTypeStateIssuer
Y35577OtherMABCBS OF MA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000061 NY Practitioner - Chiropractic 9638263130 Practice locations: Fayetteville, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7000 E Genesee St
Al 01
Fayetteville, NY 13066-1131
Phone (315) 663-1939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3539NYMDChiropractor
003539NYMDInternal Medicine Physician
770MAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1861556813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 KENWOOD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13208",
            "telephone_number": "315-663-1939",
            "fax_number": "315-663-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 COMMERCIAL ST",
            "address_2": "WHALERS WHARF",
            "city": "PROVINCETOWN",
            "state": "MA",
            "postal_code": "026572102",
            "telephone_number": "508-487-3799",
            "fax_number": "508-487-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "DONNA",
        "middle_name": "KATHREEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "3539",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "Y35577",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provincetown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.