Individual provider Active NPI

Wendy Leigh Heusch, DO

  • Orthopaedic Surgery Physician
  • Puyallup, WA
National Provider Identifier
1912958562
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OP00002091 Issued in WA
Practice address
3801 5TH St SE
Suite 110
Puyallup, WA 98374-2106
Phone
(253) 845-9585
Fax
(253) 435-4785
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OP00002091 WA Primary

Addresses

Primary practice location

3801 5TH St SE
Suite 110
Puyallup, WA 98374-2106

Mailing address

805 Madison Street
Suite 901
Seattle, WA 98104
Phone (206) 264-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20061117000471 WA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3870536147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

3801 5TH St SE
Suite 110
Puyallup, WA 98374-2106
Phone (253) 845-9585

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP00002091WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. CurrentSince Apr 1, 2007 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Apr 1, 2007 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery Past Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients
Tuckahoe Orthopaedic Associates, LTD Orthopaedic Surgery PastSince Dec 18, 2022 Accepting new patients

Locations

20920 State Route 410 E
Bonney Lake, WA 98391
Phone (253) 845-9585

3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: wendy.heusch.p83@direct.proliance.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1912958562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON STREET",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98104",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 5TH ST SE",
            "address_2": "SUITE 110",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742106",
            "telephone_number": "253-845-9585",
            "fax_number": "253-435-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEUSCH",
        "first_name": "WENDY",
        "middle_name": "LEIGH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "OP00002091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.