DR. JOSEPH D. HEINEMAN M.D.
NPI 1154394096
Urology in Newport, RI

Q: What is Joseph Heineman's NPI number?

The NPI number for Joseph Heineman is 1154394096. It was assigned to this individual provider in the NPPES registry on February 10, 2006.

Q: What is Joseph Heineman's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Joseph Heineman was last updated on February 5, 2010. 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.

Active since February 10, 2006PECOS EnrolledAccepts Medicare Assignment

93.27/100

CMS Quality Rating

38 POWEL AVE, NEWPORT, RI 02840(401) 847-2418(401) 619-1028 Get Directions Write a Review

NPPES record last updated: February 5, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Joseph D. Heineman M.d. NPPES

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

DR. JOSEPH D. HEINEMAN M.D. (NPI 1154394096) is an individual urology provider in Newport, Rhode Island, licensed in Rhode Island (MD10348) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with South County Hospital Inc, and is a graduate of Boston University School Of Medicine (1994).

NPPES Registry Identity

NPI1154394096

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. JOSEPH D. HEINEMANCredential: M.D.

Location Address38 POWEL AVENewport, RI 02840-2655

Mailing Address38 Powel AveNewport, RI 02840-2655 · (401) 847-2418 · Fax (401) 619-1028

Phone(401) 847-2418

Fax(401) 619-1028

Sole ProprietorNo

Medical School CMSBoston University School Of MedicineGraduated 1994

Enumeration DateFebruary 10, 2006

Last NPPES UpdateFebruary 5, 2010

✔ NPI 1154394096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in RI · MD10348

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

38 POWEL AVE, Newport, RI 02840

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Other Identifiers 3

Medicare ID-Type Unspecified007008228RI

Medicare UPINH13774RI

Medicaid7008228RI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Joseph D. Heineman 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 ID5496781338

PECOS Enrollment IDI20101103001034, I20250916003093

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 Reassignment

Medicare enrollment records show Joseph Heineman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mill Hill Medical Consultants Inc

86 mi

Hospitalist

20 YORK ST, CB 2041
New Haven, CT 06510

Reassigned Medicare billing, Connecticut and Rhode Island enrollments
Medicare enrollment name: Northeast Medical Group Inc
Also billed through NPI 1043278351 (Rhode Island)
1,824 clinicians in this Medicare group

NPI 1952624769 (203) 688-4741

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

Areas of Expertise CMS Part B claims 18

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.

363 services263 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

167 services131 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

141 services106 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.

89 services71 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

63 services54 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

58 services58 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

34 services31 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

30 services28 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

26 services24 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

22 services16 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

19 services19 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

19 services18 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

18 services15 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

13 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

13 services13 patients

Placement of device in prostate for radiation therapy 55876

This procedure involves placing a small device in the gland below the bladder to deliver radiation therapy. This helps target therapy directly to the concerned area, potentially reducing side effects and improving treatment effectiveness.

12 services12 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

12 services11 patients

Injection of biodegradable material next to prostate 55874

This procedure involves the introduction of a biodegradable substance near a gland located in the lower abdomen. This substance helps to create a barrier between the gland and nearby tissues, aiding in the precise delivery of treatment to the intended area.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

South County Hospital Inc

Acute Care Hospitals · Wakefield, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410008

Location100 Kenyon AveWakefield, RI 02879 · Washington County

Emergency services Birthing friendly

Kent County Memorial Hospital

Acute Care Hospitals · Warwick, RI

3/5 CMS rating

OwnershipProprietary

CMS Certification Number410009

Location455 Toll Gate RdWarwick, RI 02886 · Kent County

Emergency services Birthing friendly

The Miriam Hospital

Acute Care Hospitals · Providence, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410012

Location164 Summit AvenueProvidence, RI 02906 · Providence County

Emergency services

Westerly Hospital

Acute Care Hospitals · Westerly, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410013

Location25 Wells StreetWesterly, RI 02891 · Washington County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02840 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

$134.17 typical visit price

range $58.57 – $177.03

Typical copayment $33.54 (range $14.64 – $44.25)

Most-billed visit code 99204

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

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.

93.27/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.72

Promoting Interoperability

78.03

Improvement Activities

Other Providers at the Same Location NPPES 3

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

DR. RICHARD TAYLOR ZUERNER M.D.

Urology

38 POWEL AVE
NEWPORT, RI 02840

Newport County (401) 847-2418

DR. ARNOLD A. SARAZEN M.D.

Urology

38 POWEL AVE
NEWPORT, RI 02840

Newport County (401) 847-2418

DR. JOHN PHILIP HEFFERNAN M.D.

Urology

38 POWEL AVE
NEWPORT, RI 02840

Newport County (401) 847-2418

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 Joseph Heineman's NPI number?

The NPI number for Joseph Heineman is 1154394096. It was assigned to this individual provider in the NPPES registry on February 10, 2006.

Where is Joseph Heineman located?

Joseph Heineman practices at 38 Powel Ave, Newport, RI 02840. The listed phone number is (401) 847-2418.

What is Joseph Heineman's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Joseph Heineman enrolled in Medicare?

Yes. Joseph Heineman 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.

Which organization bills Medicare for Joseph Heineman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Heineman reassigns Medicare benefits to Mill Hill Medical Consultants Inc (New Haven, CT). The 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 Joseph Heineman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Joseph Heineman affiliated with any hospitals?

According to CMS data, Joseph Heineman is affiliated with South County Hospital Inc, Kent County Memorial Hospital, The Miriam Hospital and Westerly Hospital.

When was this NPI record last updated?

The NPPES record for Joseph Heineman was last updated on February 5, 2010. 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.