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CLAUDIA WINOGRAD HEISE M.D. PH.D.
NPI 1649616319
Family Medicine in Scarborough, ME

Active since May 21, 2013PECOS EnrolledAccepts Medicare AssignmentCLIA 20D2183031 · Waiver
20 MUSSEY RD, STE 2, SCARBOROUGH, ME 04074(207) 535-1880 Get Directions Write a Review

NPPES record last updated: June 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 29, 2020, May 31, 2020 (2 updates tracked since 2020).

About Claudia Winograd Heise M.d. Ph.d. NPPES

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

CLAUDIA WINOGRAD HEISE M.D. PH.D. (NPI 1649616319) is an individual family medicine provider in Scarborough, Maine, licensed in Maine (MD21296) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 28, 2028, and is affiliated with Northern Light Health.

NPPES Registry Identity

NPI1649616319
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCLAUDIA WINOGRAD HEISECredential: M.D. PH.D.
Location Address20 MUSSEY RD, STE 2Scarborough, ME 04074-9570
Mailing Address20 Mussey Rd Ste 2Scarborough, ME 04074-9570 · (207) 885-1333 · Fax (207) 885-1337
Phone(207) 535-1880
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMay 21, 2013
Last NPPES UpdateJune 29, 20202 updates tracked since enumeration
NPPES CertifiedJune 29, 2020
✔ NPI 1649616319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ME · MD21296
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.
20 MUSSEY RD, Scarborough, ME 04074
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Other Names 1

Former Name (1)Claudia Winograd Md Phd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.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

Claudia Winograd Heise M.d. Ph.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 ID4385874973
PECOS Enrollment IDI20161018001981
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2183031

Dr Claudia Heise/Whole Medicine · Scarborough, ME
Active · expires Apr 28, 2028
CLIA Number20D2183031
Laboratory TypePhysician Office
Certificate Effective DateApril 29, 2026
Certificate Expiration DateApril 28, 2028
Laboratory DirectorClaudia Heise MD
Laboratory Phone(207) 885-1333
Laboratory LocationDr Claudia Heise/Whole Medicine20 Mussey Road, Suite 2, Scarborough, ME 04074
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.
77 services40 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
41 services30 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
39 services39 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
36 services36 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
26 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Northern Light Health

Acute Care Hospitals · Portland, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number200008
Location144 State StreetPortland, ME 04101 · Cumberland County
Emergency services Birthing friendly

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04074 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
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.

Other Providers at the Same Location NPPES 4

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

KRISTEN ALYSE SCOPAZ MD
Family Medicine
20 MUSSEY RD
SCARBOROUGH, ME 04074
Cumberland County (207) 885-1333
SOUTHERN MAINE PSYCHOTHERAPY LLC
Social Worker (Clinical)
20 MUSSEY RD
SCARBOROUGH, ME 04074
Cumberland County (207) 200-5621
MICHAEL JOHNSTON LCSW
Social Worker (Clinical)
20 MUSSEY RD
SCARBOROUGH, ME 04074
Cumberland County (207) 838-0512
GWENDOLYN OGUIN DO
Family Medicine
20 MUSSEY RD, SUITE 2
SCARBOROUGH, ME 04074
Cumberland County (207) 885-1333

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 Claudia Heise's NPI number?

The NPI number for Claudia Heise is 1649616319. It was assigned to this individual provider in the NPPES registry on May 21, 2013. The provider is also known as Claudia Winograd MD Phd.

Where is Claudia Heise located?

Claudia Heise practices at 20 Mussey Rd Ste 2, Scarborough, ME 04074. The listed phone number is (207) 535-1880.

What is Claudia Heise's specialty?

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

Is Claudia Heise enrolled in Medicare?

Yes. Claudia Heise 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.

Does Claudia Heise hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2183031) is associated with this NPI, valid through April 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Claudia Heise accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Claudia Heise 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 Claudia Heise affiliated with any hospitals?

According to CMS data, Claudia Heise is affiliated with Northern Light Health and Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Claudia Heise was last updated on June 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.