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DR. JAMES S HEINZEN M.D.
NPI 1013908409
Emergency Medicine in Berlin, WI

Active since November 03, 2005PECOS Enrolled
225 MEMORIAL DR, BERLIN, WI 54923(920) 361-5525(920) 361-5925 Get Directions Write a Review

NPPES record last updated: May 17, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. James S Heinzen M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES S HEINZEN M.D. (NPI 1013908409) is an individual emergency medicine provider in Berlin, Wisconsin, licensed in Wisconsin (39061) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hartford.

NPPES Registry Identity

NPI1013908409
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. JAMES S HEINZENCredential: M.D.
Location Address225 MEMORIAL DRBerlin, WI 54923-1243
Mailing Address225 Memorial DrBerlin, WI 54923-1243 · (920) 361-5525 · Fax (920) 361-5925
Phone(920) 361-5525
Fax(920) 361-5925
Sole ProprietorNo
Enumeration DateNovember 3, 2005
Last NPPES UpdateMay 17, 2022
NPPES CertifiedMay 17, 2022
✔ NPI 1013908409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in WI · 39061
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 39061-020 (WI)
225 MEMORIAL DR, Berlin, WI 54923
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Secondary Practice Location 1

Location 11032 E Sumner StHartford, WI 53027-1608 · Phone (262) 673-2300

Other Identifiers 2

Other60729WI · Dean Health Insurance
Medicaid32402700WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. James S Heinzen M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

8

Medicare enrollment records show James Heinzen reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Thedacare Medical Center - Berlin, Inc.
Same address
Anesthesiology
225 MEMORIAL DR
Berlin, WI 54923
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1760413777 (Wisconsin)
  • 104 clinicians in this Medicare group
NPI 1275943367 (920) 361-5538
Thedacare Regional Medical Center - Appleton, Inc.
20 mi
General Acute Care Hospital
250 W. 6TH AVENUE
Oshkosh, WI 54902
  • Reassigned Medicare billing, Wisconsin enrollment
  • 35 clinicians in this Medicare group
NPI 1912880329 (920) 731-4101
Thedacare Medical Center - Wild Rose, Inc
21 mi
Critical Access
601 GROVE AVE
Wild Rose, WI 54984
  • Reassigned Medicare billing, Wisconsin enrollment
  • 28 clinicians in this Medicare group
NPI 1043263999 (920) 622-3257
Thedacare Medical Center - Waupaca, Inc.
24 mi
Critical Access
N2610 WI 22
Waupaca, WI 54981
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1780782680 (Wisconsin)
  • 85 clinicians in this Medicare group
NPI 1710333893 (715) 258-1021
Thedacare Medical Center - New London, Inc.
30 mi
Critical Access
1405 MILL ST
New London, WI 54961
  • Reassigned Medicare billing, Wisconsin enrollment
  • 56 clinicians in this Medicare group
NPI 1538127220 (920) 531-2092
Thedacare Medical Center - Shawano, Inc.
55 mi
Critical Access
100 COUNTY ROAD B
Shawano, WI 54166
  • Reassigned Medicare billing, Wisconsin enrollment
  • 70 clinicians in this Medicare group
NPI 1548260839 (715) 526-2111
Aspirus Merrill Hospital & Clinics, Inc.
91 mi
Critical Access
601 S CENTER AVE
Merrill, WI 54452
  • Reassigned Medicare billing, Wisconsin enrollment
  • 351 clinicians in this Medicare group
NPI 1124084678 (715) 536-5511
Emergency Physician Associates Of Wisconsin Sc
100 mi
Emergency Medicine
3100 SHORE DR
Marinette, WI 54143
  • Reassigned Medicare billing, Wisconsin enrollment
  • 59 clinicians in this Medicare group
NPI 1396119426 (715) 735-4200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54923 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$119.49 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$38.25 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. COURTNEY DISTERHAFT DPT
Physical Therapist
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
BARRY L ROGERS MD
Surgery
225 MEMORIAL DR, STE 2000
BERLIN, WI 54923
Green Lake County (920) 361-5340
CENTRAL WISCONSIN ANESTHESI
Anesthesiology
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538
JESSICA JO TOMASIEWICZ
Nurse Anesthetist, Certified Registered
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538
EMILY ANNE RADEMACHER COTA
Occupational Therapy Assistant
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
DANIEL KENNETH LEMBERGER APNP
Nurse Practitioner (Adult Health)
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-1313
TONY D SINGH CRNA
Nurse Anesthetist, Certified Registered
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 361-5538
THEDACARE MEDICAL CENTER - BERLIN, INC.
Pharmacy (Community/Retail Pharmacy)
225 MEMORIAL DR
BERLIN, WI 54923
Green Lake County (920) 291-5768

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Heinzen's NPI number?

The NPI number for James Heinzen is 1013908409. It was assigned to this individual provider in the NPPES registry on November 3, 2005.

Where is James Heinzen located?

James Heinzen practices at 225 Memorial Dr, Berlin, WI 54923. The listed phone number is (920) 361-5525.

What is James Heinzen's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is James Heinzen enrolled in Medicare?

Yes. James Heinzen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for James Heinzen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Heinzen reassigns Medicare benefits to 8 organizations: Thedacare Medical Center - Berlin, Inc. (Berlin, WI), Thedacare Regional Medical Center - Appleton, Inc. (Oshkosh, WI), Thedacare Medical Center - Wild Rose, Inc (Wild Rose, WI), Thedacare Medical Center - Waupaca, Inc. (Waupaca, WI), Thedacare Medical Center - New London, Inc. (New London, WI) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Heinzen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Heinzen accept?

Health plans from CareSource (Common Ground Healthcare) list James Heinzen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Heinzen was last updated on May 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.