Individual provider Active NPI

Marie-Paule Simone Heylen, ANP-C

  • Adult Health Nurse Practitioner
  • Potsdam, NY
National Provider Identifier
1891042644
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306058-1 Issued in NY
Practice address
6805 US Highway 11
Potsdam, NY 13676-3131
Phone
(315) 265-3105
Fax
(315) 265-0323
NPI assigned
Aug 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306058-1 NY Primary

Addresses

Primary practice location

6805 US Highway 11
Potsdam, NY 13676-3131

Mailing address

6805 US Highway 11
Potsdam, NY 13676-3131
Phone (315) 265-3105

Other identifiers 1

IdentifierTypeStateIssuer
03497023MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT, ME, NH4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20121017000607 NY Practitioner - Nurse Practitioner 5698925253 Reassigns benefits to 2 organizations
I20221005000741 CT Practitioner - Nurse Practitioner 5698925253 Reassigns benefits to 2 organizations
I20230202000765 ME Practitioner - Nurse Practitioner 5698925253 Reassigns benefits to 2 organizations
I20230207002380 NH Practitioner - Nurse Practitioner 5698925253 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F306058-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Health Me, LLC CurrentSince Jan 1, 2023 Accepting new patients
Bridge Health PLLC CurrentSince Jun 27, 2024 Accepting new patients
Garumuni Anura Desilva, MD PC CurrentSince May 1, 2022 Accepting new patients
Hospice of St Lawrence Valley Inc CurrentSince Feb 1, 2014 Accepting new patients

Locations

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

180 Low St
Newburyport, MA 01950
Phone (978) 465-5361

188 Eastern Ave
Augusta, ME 04330
Phone (207) 622-3121

323 State St
Ste 5
Augusta, ME 04330
Phone (207) 370-6470

370 Portland St
Yarmouth, ME 04096
Phone (207) 846-9021

307 Plaza Dr
Dover, NH 03820
Phone (207) 775-4000

170 Commerce Way
Ste 200
Portsmouth, NH 03801
Phone (201) 293-7689

20 E Sunrise Hwy
Fl 2
Valley Stream, NY 11581
Phone (516) 543-6249

10125 Verree Rd
Ste 202
Philadelphia, PA 19116
Phone (215) 302-2003

Interoperability endpoints

  • Direct secure messaging: mheylen@hiemail.healtheconnections.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1891042644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 US HIGHWAY 11",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763131",
            "telephone_number": "315-265-3105",
            "fax_number": "315-265-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 US HIGHWAY 11",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763131",
            "telephone_number": "315-265-3105",
            "fax_number": "315-265-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYLEN",
        "first_name": "MARIE-PAULE",
        "middle_name": "SIMONE",
        "name_prefix": "Mrs.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-11",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306058-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03497023",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.