DR. JOHN PHILIP HEFFERNAN M.D.
NPI 1649243643
Urology in Newport, RI

Q: What is John Heffernan's NPI number?

The NPI number for John Heffernan is 1649243643. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Q: What is John Heffernan'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 John Heffernan was last updated on January 25, 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 09, 2006PECOS EnrolledAccepts Medicare Assignment

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

NPPES record last updated: January 25, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. John Philip Heffernan M.d. NPPES

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

DR. JOHN PHILIP HEFFERNAN M.D. (NPI 1649243643) is an individual urology provider in Newport, Rhode Island, licensed in Rhode Island (MD09513) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Southcoast Hospitals Group, and is a graduate of Georgetown University School Of Medicine (1986).

NPPES Registry Identity

NPI1649243643

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. JOHN PHILIP HEFFERNANCredential: 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 ProprietorYes

Medical School CMSGeorgetown University School Of MedicineGraduated 1986

Enumeration DateFebruary 9, 2006

Last NPPES UpdateJanuary 25, 2010

✔ NPI 1649243643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in RI · MD09513

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 Unspecified007006003RI

Medicare UPINF35486RI

Medicaid7006003RI

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. John Philip Heffernan 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 ID143414136

PECOS Enrollment IDI20101103001097

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 22

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 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.

542 services486 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.

534 services416 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

502 services435 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.

236 services214 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.

111 services88 patients

Complicated insertion of bladder tube 51703

This procedure involves placing a tube into your bladder to help with urine flow. It may be needed if you have trouble urinating naturally. The process requires specialized skill due to certain complexities but is done with utmost care for your comfort.

87 services28 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

85 services18 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.

78 services11 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.

78 services78 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

58 services23 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

55 services37 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

54 services48 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

50 services48 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

43 services32 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

33 services31 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

25 services19 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.

25 services25 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

20 services18 patients

Insertion of temporary bladder tube 51701

This procedure involves placing a small tube into your lower abdomen to help drain urine from your bladder. It's a temporary measure, often used when normal urination is not possible. The tube remains in place until you can urinate on your own again.

15 services11 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.

15 services15 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

12 services12 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Southcoast Hospitals Group

Acute Care Hospitals · Fall River, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220074

Location363 Highland AvenueFall River, MA 02720 · Bristol County

Emergency services Birthing friendly

Our Lady Of Fatima Hospital

Acute Care Hospitals · North Providence, RI

3/5 CMS rating

OwnershipProprietary

CMS Certification Number410005

Location200 High Service AvenueNorth Providence, RI 02904 · Providence County

Emergency services

Newport Hospital

Acute Care Hospitals · Newport, RI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410006

Location11 Friendship StreetNewport, RI 02840 · Newport County

Emergency services Birthing friendly

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

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

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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

9 suppliers53 claims12,221 services$1.71 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

3 suppliers20 claims3,220 services$3.71 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

3 suppliers21 claims51 services$7.67 avg. paid by Medicare

Lubricant, per ounce A4402

DME-Orthotic Devices · category DF010N

2 suppliers18 claims152 services$1.31 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Patrick ***** May 23, 2025

5/5

Outstanding doctor --care is excellent considerate---makes sincere effort to explain all procedures---is easy to talk to and discuss concerns

Provider 5/5 Office Staff 5/5

Visited this provider? Share your experience.

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. JOSEPH D. HEINEMAN M.D.

Urology

38 POWEL AVE
NEWPORT, RI 02840

Newport County (401) 847-2418

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

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 John Heffernan's NPI number?

The NPI number for John Heffernan is 1649243643. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Where is John Heffernan located?

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

What is John Heffernan's specialty?

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

Is John Heffernan enrolled in Medicare?

Yes. John Heffernan 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.

Is John Heffernan affiliated with any hospitals?

According to CMS data, John Heffernan is affiliated with Southcoast Hospitals Group, Our Lady Of Fatima Hospital, Newport Hospital, South County Hospital Inc and The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for John Heffernan was last updated on January 25, 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.

About Dr. John Philip Heffernan M.d. NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 3

Medicare Participation & PECOS CMS

Medicare Enrollment Status

Areas of Expertise CMS Part B claims 22

Hospital Affiliations CMS Care Compare 5

Southcoast Hospitals Group

Our Lady Of Fatima Hospital

Newport Hospital

South County Hospital Inc

The Miriam Hospital

Physician Visit Costs CMS claims · ZIP area

Referred Medical Equipment & Supplies CMS DME claims 4

Patient Reviews User submitted

Review by Patrick ***** · May 23, 2025

Other Providers at the Same Location NPPES 3

Frequently Asked Questions NPPES & CMS

What is John Heffernan's NPI number?

Where is John Heffernan located?

What is John Heffernan's specialty?

Is John Heffernan enrolled in Medicare?

Is John Heffernan affiliated with any hospitals?

When was this NPI record last updated?

Review by Patrick ***** May 23, 2025