Active NPI
Jose M Heisecke, MD..
- Surgery Physician
- Pittsfield, MA
National Provider Identifier
1962671909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 231102
- Practice address
- 777 North St Ste 407
Pittsfield, MA 01201-4172 - Phone
- (413) 445-6420
- Fax
- (413) 499-4907
- NPI assigned
- Feb 25, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 231102 | MA | |
| Surgery Physician | 208600000X | 231102 | MA | Primary |
Addresses
Primary practice location
777 North St Ste 407
Pittsfield, MA 01201-4172
Mailing address
777 North St Ste 407
PO Box 1677
Pittsfield, MA 01201-4172
Phone (413) 445-6420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227571200000",
"number": "1962671909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 NORTH ST STE 407",
"address_2": "PO BOX 1677",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012014172",
"telephone_number": "413-445-6420",
"fax_number": "413-499-4907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 NORTH ST STE 407",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012014172",
"telephone_number": "413-445-6420",
"fax_number": "413-499-4907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISECKE",
"first_name": "JOSE",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "MD..",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-25",
"last_updated": "2008-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "231102",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "231102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.