Individual provider Active NPI

Susan H Heller, M.D.

  • Pediatrics Physician
  • Irving, TX
National Provider Identifier
1891869095
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J0833 Issued in TX
Practice address
2021 N Macarthur Blvd
Ste 250
Irving, TX 75061-2219
Phone
(972) 253-4360
Fax
(972) 253-4327
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J0833 TX Primary

Addresses

Primary practice location

2021 N Macarthur Blvd
Ste 250
Irving, TX 75061-2219

Mailing address

2021 N Macarthur Blvd
Ste 150
Irving, TX 75061-2219
Phone (972) 253-2560

Other identifiers 1

IdentifierTypeStateIssuer
092409401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180516000790 TX Practitioner - Pediatric Medicine 0042574204 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 7, 2018 Accepting new patients
Healthtexas Provider Network Pediatrics CurrentSince Jul 7, 2018 Accepting new patients
Medical & Surgical Clinic of Irving, P.a. Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Medical & Surgical Clinic of Irving, P.a. Pediatrics Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

6750 N MacArthur Blvd
Ste 206
Irving, TX 75039
Phone (972) 406-9911

2021 N MacArthur Blvd
Ste 250
Irving, TX 75061
Phone (972) 253-4300

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1891869095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 N MACARTHUR BLVD",
            "address_2": "STE 150",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612219",
            "telephone_number": "972-253-2560",
            "fax_number": "972-253-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N MACARTHUR BLVD",
            "address_2": "STE 250",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612219",
            "telephone_number": "972-253-4360",
            "fax_number": "972-253-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "SUSAN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092409401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.