NPIMap

Individual provider Active NPI

Amita Heaser, M.D.

  • Internal Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1902062219
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-127885 Issued in IL
Practice address
6801 Rogers Ave
Fort Smith, AR 72903-4067
Phone
(479) 274-4100
Fax
(479) 274-4199
NPI assigned
Aug 6, 2008
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-127885 IL Primary
Internal Medicine Physician 207R00000X 125054221 IL
Internal Medicine Physician 207R00000X E9240 AR

Addresses

Primary practice location

6801 Rogers Ave
Fort Smith, AR 72903-4067

Mailing address

PO Box 17025
Fort Smith, AR 72917-7025
Phone (479) 274-2000

Other identifiers 3

IdentifierTypeStateIssuer
036127885MedicaidIL
5BA25OtherARARKANSAS BLUECROSS BLUE SHIELD
04515143OtherILBCBS#

Other names 1

  • Amita Mukherjee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20150806011966 AR Practitioner - Internal Medicine 0446429864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6801 Rogers Ave
Fort Smith, AR 72903-4067
Phone (479) 274-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E9240ARMDInternal Medicine Physician
036-127885ILMDInternal Medicine Physician
125054221ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 1, 2017 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 1, 2017 Accepting new patients

Locations

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Interoperability endpoints

  • Direct secure messaging: aheaser978147@directc.mercy.net

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1902062219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17025",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729177025",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-4100",
            "fax_number": "479-274-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEASER",
        "first_name": "AMITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-127885",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125054221",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E9240",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127885",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUECROSS BLUE SHIELD",
            "identifier": "5BA25",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS#",
            "identifier": "04515143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMITA",
            "last_name": "MUKHERJEE",
            "credential": "M.D,",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.