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JAMES R HEABERLIN M.D.
NPI 1043604960
Orthopaedic Surgery - Hand Surgery in Wauwatosa, WI

Active since March 28, 2015PECOS EnrolledAccepts Medicare Assignment
2999 N MAYFAIR RD, WAUWATOSA, WI 53222(414) 479-7000(414) 479-7001 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 12, 2024, Dec 1, 2022, Dec 2, 2021 and 1 more (4 updates tracked since 2021).

About James R Heaberlin M.d. NPPES

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

JAMES R HEABERLIN M.D. (NPI 1043604960) is an individual hand surgery provider in Wauwatosa, Wisconsin, licensed in Wisconsin (75451) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Washington County, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1043604960
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameJAMES R HEABERLINCredential: M.D.
Location Address2999 N MAYFAIR RDWauwatosa, WI 53222-4306
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Phone(414) 479-7000
Fax(414) 479-7001
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2015
Enumeration DateMarch 28, 2015
Last NPPES UpdateAugust 12, 20244 updates tracked since enumeration
NPPES CertifiedAugust 12, 2024
✔ NPI 1043604960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License✔ Licensed in WI · 75451
Definition

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 75451 (WI)
2999 N MAYFAIR RD, Wauwatosa, WI 53222
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11740 W Taylor StChicago, IL 60612-7232 · Phone (866) 600-2273
Location 22900 W Oklahoma AveMilwaukee, WI 53215-4330 · Phone (414) 649-6000

Other Identifiers 1

Medicaid100177689WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.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

James R Heaberlin 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 ID8820307101
PECOS Enrollment IDI20210819001144
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 7

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
192 services63 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
146 services123 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
84 services84 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
47 services42 patients
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.
26 services26 patients
Aspiration and/or injection of fluid from small joint 20600
This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.
23 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Aurora Medical Ctr Washington County

Acute Care Hospitals · Hartford, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520038
Location1032 E Sumner StHartford, WI 53027 · Washington County
Emergency services

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520138
Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County
Emergency services Birthing friendly

Aurora Medical Center

Acute Care Hospitals · Grafton, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520207
Location975 Port Washington RoadGrafton, WI 53024 · Ozaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53222 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
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
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

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

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
4 suppliers25 claims30 services$23.60 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.

LINDA SNYDER
Physical Therapist (Orthopedic)
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-1945
MEGAN E WILEY DPT
Physical Therapist
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-3737
DR. LUKE JEFFERY WIRKUS DPT
Physical Therapist
2999 N MAYFAIR RD, SUITE 300
WAUWATOSA, WI 53222
Milwaukee County (414) 479-3747
JOHN CHENG PT
Physical Therapist
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-3737
STACEY SIPIORSKI
Physical Therapist
2999 N MAYFAIR RD, SUITE 300
WAUWATOSA, WI 53222
Milwaukee County (414) 479-3737
ELISE NICKEL
Physical Therapy Assistant
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-3737
DR. BENJAMIN A ABEYTA M.D.
Family Medicine (Sports Medicine)
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-7000
DIANE M. FOTI OTR, CHT
Occupational Therapist
2999 N MAYFAIR RD
WAUWATOSA, WI 53222
Milwaukee County (414) 479-7304

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 Heaberlin's NPI number?

The NPI number for James Heaberlin is 1043604960. It was assigned to this individual provider in the NPPES registry on March 28, 2015.

Where is James Heaberlin located?

James Heaberlin practices at 2999 N Mayfair Rd, Wauwatosa, WI 53222. The listed phone number is (414) 479-7000.

What is James Heaberlin's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is James Heaberlin enrolled in Medicare?

Yes. James Heaberlin 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 James Heaberlin accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Quartz and 1 other insurer list James Heaberlin 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 James Heaberlin affiliated with any hospitals?

According to CMS data, James Heaberlin is affiliated with Aurora Medical Ctr Washington County, Aurora St Lukes Medical Center and Aurora Medical Center.

When was this NPI record last updated?

The NPPES record for James Heaberlin was last updated on August 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.