NPIMap

Individual provider Active NPI

Blake Anthony Heinz, D.O.

  • Internal Medicine Physician
  • Aberdeen, SD
National Provider Identifier
1871869172
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9584 Issued in SD
Practice address
815 1St Ave SE
Suite 104
Aberdeen, SD 57401-4602
Phone
(605) 622-5458
Fax
(605) 622-5473
NPI assigned
Mar 30, 2012
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 9584 SD Primary

Addresses

Primary practice location

815 1St Ave SE
Suite 104
Aberdeen, SD 57401-4602

Mailing address

PO Box 1460
Aberdeen, SD 57402-1460
Phone (605) 622-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20150812007020 SD Practitioner - Internal Medicine 9931414596 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Physicians and Surgeons, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5100

8 E US Hwy 12
Groton, SD 57445-2176
Phone (605) 397-4242

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke's CurrentSince Aug 17, 2015 Accepting new patients
Avera McKennan CurrentSince Jul 30, 2017 Accepting new patients
Avera St Marys CurrentSince Jun 1, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera St. Luke's Internal Medicine Current Accepting new patients
Avera Queen of Peace CurrentSince Mar 14, 2018 Accepting new patients
Avera Queen of Peace CurrentSince Mar 14, 2018 Accepting new patients
Avera McKennan CurrentSince Jul 30, 2017 Accepting new patients
Avera St. Lukes CurrentSince Aug 17, 2015 Accepting new patients
Avera St Marys Current Accepting new patients
Avera McKennan Current Accepting new patients
Avera St Marys CurrentSince Jun 1, 2018 Accepting new patients
Burnett Medical Center Inc Past Accepting new patients
Avera St Lukes Past Accepting new patients
Avera St Lukes Past Accepting new patients

Locations

815 1st Ave SE
Ste 104
Aberdeen, SD 57401
Phone (605) 225-0378

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

Interoperability endpoints

  • Direct secure messaging: bheinz1029679@direct.unitypoint.org
  • Direct secure messaging: bheinz3932425@direct.trinity-health.org
  • Direct secure messaging: bheinz824622@direct.centracare.com
  • Direct secure messaging: blake.heinz.1@11418.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avera St. Luke'sAberdeen, SD, CCN 430014 Hospital Corporate Director Jul 1, 2024
Avera St LukesAberdeen, SD, CCN 43S014 Hospital Corporate Director Jul 1, 2025
Avera St LukesAberdeen, SD, CCN 43U014 Hospital Corporate Director Jul 1, 2025
Avera Mother Joseph ManorAberdeen, SD, CCN 435042 Skilled nursing facility Corporate Director Jul 1, 2024
Avera Eureka Health Care CenterEureka, SD, CCN 435078 Skilled nursing facility Managing Control - Governing Body Jul 1, 2024
Avera Ellendale ClinicEllendale, ND, CCN 353837 Rural health clinic Corporate Director Jul 1, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1871869172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-2857",
            "fax_number": "605-622-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 1ST AVE SE",
            "address_2": "SUITE 104",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014602",
            "telephone_number": "605-622-5458",
            "fax_number": "605-622-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "BLAKE",
        "middle_name": "ANTHONY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-30",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "9584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.