Individual provider Active NPI

John Timothy Heffernan, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
National Provider Identifier
1972915627
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD60968447 Issued in WA
Practice address
7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Phone
(253) 582-7257
Fax
(253) 582-1617
NPI assigned
May 29, 2014
Last updated
Aug 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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 MD60968447 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000

Mailing address

7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Phone (253) 582-7257

Other practice location 1

1724 W Union Ave Ste 100
Tacoma, WA 98405-2099
Phone (253) 830-5200

Other practice location 2

2727 Hollycroft St Ste 410
Gig Harbor, WA 98335-1369
Phone (253) 358-4002

Other identifiers 1

IdentifierTypeStateIssuer
2154663MedicaidWA

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
I20200820001247 WA Practitioner - Orthopedic Surgery 2769716109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 2014
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)

1724 W Union Ave
Suite 100
Tacoma, WA 98405-2099
Phone (253) 830-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Aug 17, 2020 Accepting new patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery CurrentSince Aug 17, 2020 Accepting new patients
Proliance Surgeons Inc., P.S. Orthopaedic Surgery Past Accepting new patients

Locations

2727 Hollycroft St
Ste 410
Gig Harbor, WA 98335
Phone (253) 358-4002

7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

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

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

Interoperability endpoints

  • Direct secure messaging: john.heffernan.p73@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 6

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1972915627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 W Union Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052099",
            "country_code": "US",
            "telephone_number": "253-830-5200",
            "fax_number": "253-752-1160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 Hollycroft St Ste 410",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983351369",
            "country_code": "US",
            "telephone_number": "253-358-4002",
            "fax_number": "253-358-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "JOHN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60968447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2154663",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.