DR. RONALD W HEINE M.D.
NPI 1013912716
Family Medicine in Athens, TX

Active since June 17, 2005PECOS EnrolledAccepts Medicare Assignment
63.38/100
CMS Quality Rating
117 MEDICAL CIRCLE, ATHENS, TX 75751(903) 676-3200(903) 676-3277 Get Directions Write a Review

NPPES record last updated: October 16, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ronald W Heine M.d. NPPES

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

DR. RONALD W HEINE M.D. (NPI 1013912716) is an individual family medicine provider in Athens, Texas, licensed in Texas (G2988) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of University Of Oklahoma College Of Medicine (1982).

NPPES Registry Identity

NPI1013912716
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RONALD W HEINECredential: M.D.
Location Address117 MEDICAL CIRCLEAthens, TX 75751
Mailing Address117 Medical CircleAthens, TX 75751 · (903) 676-3200 · Fax (903) 676-3277
Fax(903) 676-3277
Sole ProprietorNo
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1982
Enumeration DateJune 17, 2005
Last NPPES UpdateOctober 16, 2009
NPI 1013912716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TX · G2988
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
117 MEDICAL CIRCLE, Athens, TX 75751

Other Identifiers 4

Medicaid139667307TX
Other80F787TX · Bcbs
Medicare UPINC16770TX
Medicare ID-Type Unspecified80F787TX · Medicare Number

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Ronald W Heine M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315076528
PECOS Enrollment IDI20100526000972
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.

Areas of Expertise CMS Part B claims 36

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
753 services224 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
491 services224 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
469 services223 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
456 services222 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
396 services211 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
261 services97 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75751 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

63.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.71
Promoting Interoperability0
Improvement Activities40
Cost75.54

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
91%290 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 17

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers14 claims40 services$6.13 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers15 claims30 services$1.82 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers24 claims24 services$109.94 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers25 claims74 services$44.26 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers17 claims17 services$21.59 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers20 claims20 services$21.50 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 5

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

Family Medicine
117 MEDICAL CIRCLE
ATHENS, TX 75751
Family Medicine
117 MEDICAL CIRCLE
ATHENS, TX 75751
Family Medicine
117 MEDICAL CIRCLE
ATHENS, TX 75751
Family Medicine
117 MEDICAL CIRCLE
ATHENS, TX 75751
Family Medicine
117 MEDICAL CIRCLE
ATHENS, TX 75751

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 Ronald Heine's NPI number?

The NPI number for Ronald Heine is 1013912716. It was assigned to this individual provider in the NPPES registry on June 17, 2005.

Where is Ronald Heine located?

Ronald Heine practices at 117 Medical Circle, Athens, TX 75751. The listed phone number is (903) 676-3200.

What is Ronald Heine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ronald Heine enrolled in Medicare?

Yes. Ronald Heine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ronald Heine accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Ronald Heine 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.

Is Ronald Heine affiliated with any hospitals?

According to CMS data, Ronald Heine is affiliated with Ut Health East Texas Tyler Regional Hospital and Ut Health East Texas Athens Hospital.

When was this NPI record last updated?

The NPPES record for Ronald Heine was last updated on October 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.