DR. MARK PATRICK HEILALA MD
NPI 1104028026
Radiology - Diagnostic Radiology in Grand Rapids, MI

Active since June 04, 2007PECOS EnrolledAccepts Medicare Assignment
84.16/100
CMS Quality Rating
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 363-7272(616) 361-5828 Get Directions Write a Review

NPPES record last updated: April 8, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mark Patrick Heilala Md NPPES

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

DR. MARK PATRICK HEILALA MD (NPI 1104028026) is an individual diagnostic radiology provider in Grand Rapids, Michigan, licensed in Michigan (4301088205) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Lake Health, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1104028026
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. MARK PATRICK HEILALACredential: MD
Location Address3264 N EVERGREEN DR NEGrand Rapids, MI 49525-9746
Mailing Address3264 N Evergreen Dr NeGrand Rapids, MI 49525-9746 · (616) 363-7272 · Fax (616) 361-5828
Fax(616) 361-5828
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJune 4, 2007
Last NPPES UpdateApril 8, 2022
NPPES CertifiedApril 8, 2022
NPI 1104028026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in MI · 4301088205
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
3264 N EVERGREEN DR NE, Grand Rapids, MI 49525

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. Mark Patrick Heilala Md 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 ID4385822543
PECOS Enrollment IDI20110617000380, I20240429002349
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 49

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.

X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
1,082 services1,040 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
624 services620 patients
Ct scan of abdomen and pelvis with contrast 74177
A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
303 services303 patients
Ct scan head or brain without contrast 70450
A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
184 services183 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
178 services166 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
173 services168 patients

Hospital Affiliations CMS Care Compare 5

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

Lake Health

Acute Care Hospitals · Concord, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360098
Location7590 Auburn RoadConcord, OH 44077 · Lake County
Emergency services

Uh St John Medical Center

Acute Care Hospitals · Westlake, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360123
Location29000 Center Ridge RoadWestlake, OH 44145 · Cuyahoga County
Emergency services

Uh Cleveland Medical Center

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360137
Location11100 Euclid AvenueCleveland, OH 44106 · Cuyahoga County
Emergency services Birthing friendly

University Hospitals - Elyria Medical Center

Acute Care Hospitals · Elyria, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360145
Location630 East River StreetElyria, OH 44035 · Lorain County

University Hospitals Ahuja Medical Center

Acute Care Hospitals · Beachwood, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360359
Location3999 Richmond RoadBeachwood, OH 44122 · Cuyahoga County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49525 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

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.

84.16/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.28
Improvement Activities40
Cost67.44

Reported Quality Measures

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
94%868 patients
Radiology: Reminder System for Screening Mammograms
Percentage of patients undergoing a screening mammogram whose information is entered into a reminder system with a target due date for the next mammogram
100%911 patients
Radiology: Stenosis Measurement in Carotid Imaging Reports
Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…
96%46 patients
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.

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.

Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Physician Assistant
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Radiology (Diagnostic Radiology)
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525

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 Mark Heilala's NPI number?

The NPI number for Mark Heilala is 1104028026. It was assigned to this individual provider in the NPPES registry on June 4, 2007.

Where is Mark Heilala located?

Mark Heilala practices at 3264 N Evergreen Dr NE, Grand Rapids, MI 49525. The listed phone number is (616) 363-7272.

What is Mark Heilala's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mark Heilala enrolled in Medicare?

Yes. Mark Heilala 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 Mark Heilala accept?

Health plans from Antidote Health Plan of Ohio, Inc., Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and CareSource list Mark Heilala 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 Mark Heilala affiliated with any hospitals?

According to CMS data, Mark Heilala is affiliated with Lake Health, Uh St John Medical Center, Uh Cleveland Medical Center, University Hospitals - Elyria Medical Center and University Hospitals Ahuja Medical Center.

When was this NPI record last updated?

The NPPES record for Mark Heilala was last updated on April 8, 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.