| Paul P Heideman, MD | |
|
252 Mchenry St, Burlington, WI 53105 | |
| (262) 767-6100 | |
| Not Available |
| Full Name | Paul P Heideman |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 15 Years |
| Location | 252 Mchenry St, Burlington, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144546870 | NPI | - | NPPES |
| ENROLLED | Medicaid | MN | |
| 1144546870 | Medicaid | WI | |
| ENROLLED | Medicaid | IA | |
| ENROLLED | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 63817 (Wisconsin) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 63817 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Memorial Hospital Burlington | Burlington, WI | Hospital |
| Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| Aurora Lakeland Medical Center | Elkhorn, WI | Hospital |
| Aurora Medical Center - Summit | Summit, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Advanced Healthcare, Inc. | 3375625833 | 1012 |
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Lakeshore Medical Clinic Llc | 7719890730 | 325 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Entity Name | Aurora Health Care Metro, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861447179 PECOS PAC ID: 8628986536 Enrollment ID: O20040114000498 |
| Entity Name | Aurora Advanced Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul P Heideman, MD Po Box 735044, Chicago, IL 60673-5044 Ph: () - | Paul P Heideman, MD 252 Mchenry St, Burlington, WI 53105 Ph: (262) 767-6100 |
Jill A Hammersley, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 252 Mchenry St, Burlington, WI 53105 Phone: 262-767-6000 | |
Dr. Elton Mustafaraj, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 252 Mchenry St, Burlington, WI 53105 Phone: 262-767-6000 |