Individual provider Active NPI

Jay Heisler, PH.D.

  • Clinical Psychologist
  • Hoover, AL
National Provider Identifier
1992856793
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1372 Issued in AL
Practice address
4515 Southlake Pkwy Ste 200
Hoover, AL 35244-3319
Phone
(205) 313-7246
Fax
(205) 939-1911
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1372 AL Primary

Addresses

Primary practice location

4515 Southlake Pkwy Ste 200
Hoover, AL 35244-3319

Mailing address

4515 Southlake Pkwy Ste 200
Hoover, AL 35244-3319
Phone (205) 313-7246

Other identifiers 2

IdentifierTypeStateIssuer
167883900OtherUS DEPT OF LABOR
051532520OtherALBCBS AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060327000335 AL Practitioner - Clinical Psychologist 7214945682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birmingham Pain Center Inc.Group PAC ID 3678522521, 4 clinicians

Practice addresses (Care Compare)

4515 Southlake Pkwy
Suite 200
Hoover, AL 35244-3319
Phone (205) 313-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1372ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Birmingham Pain Center Inc. Clinical CurrentSince Feb 1, 2006 Accepting new patients
The Birmingham Pain Center Inc CurrentSince Feb 1, 2006 Accepting new patients

Locations

4515 Southlake Pkwy
Ste 200
Hoover, AL 35244
Phone (205) 313-7246

Interoperability endpoints

  • Direct secure messaging: jay.heisler.1@12861.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12861/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1992856793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SOUTHLAKE PKWY STE 200",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443319",
            "telephone_number": "205-313-7246",
            "fax_number": "205-939-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 SOUTHLAKE PKWY STE 200",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443319",
            "telephone_number": "205-313-7246",
            "fax_number": "205-939-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISLER",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "167883900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "051532520",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.