DR. BRIAN DAVID HEEREN D.C. NPI 1750610051

Chiropractor in Portage, WI

Individual Male Years of Experience 14 Chiropractor Accepts Medicare Approved Payment

About DR. BRIAN DAVID HEEREN D.C.

Brian Heeren is a provider established in Portage, Wisconsin and his medical specialization is Chiropractor with more than 14 years of experience. He graduated from Palmer College Chiropractic - Davenport in 2009. The NPI number of Brian Heeren is 1750610051 and was assigned on December 2009. The practitioner's primary taxonomy code is 111N00000X with license number 4566-012 (WI). The provider is registered as an individual and his NPI record was last updated 13 years ago.

A chiropractor like Dr. Brian David Heeren D.c. helps patients with problems of the neuromusculoskeletal system, which includes nerves, bones, muscles, ligaments, and tendons. Chiropractors use spinal adjustments and manipulation, as well as other clinical interventions, to manage health issues such as back and neck pain. Some chiropractors apply procedures like massage therapy, rehabilitative exercise, ultrasound and spinal adjustments and manipulation. A chiropractor focuses on the patients overall health and might refer patients to other healthcare professionals if necessary.

NPI

1750610051

Provider NameDR. BRIAN DAVID HEEREN D.C.
Provider Location Address641 LATTON LN PORTAGE, WI 53901
Provider Mailing AddressW8979 KENT RD POYNETTE, WI 53955
GenderMale
NPI Entity TypeIndividual
Medical School NamePALMER COLLEGE CHIROPRACTIC - DAVENPORT
Graduation Year2009
Is Sole Proprietor?No
Enumeration Date12-15-2009
Last Update Date12-15-2009

Brian Heeren is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $0 for a new patient copayment and $17.49 for an established patient copayment.



Primary Taxonomy

Taxonomy Code111N00000X
ClassificationChiropractor
TypeChiropractic Providers
License No.4566-012
License StateWI
Taxonomy DescriptionA provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Business Address

DR. BRIAN DAVID HEEREN D.C.
641 LATTON LN
PORTAGE, WI
ZIP 53901
Phone: (608) 742-1300

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Mailing Address

DR. BRIAN DAVID HEEREN D.C.
W8979 KENT RD
POYNETTE, WI
ZIP 53955
Phone: (608) 635-2200


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

PECOS PAC ID143365783
PECOS Enrollment IDI20100306000129
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 53901 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: NA
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.63 $169.16 $0
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.9 $42.29 $0
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.46 $138.8 $69.98
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.36 $34.7 $17.49

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 1217Chiropractic manipulative treatment, 3 to 4 spinal regions (HCPCS:98941)

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750610051
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271001210010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 2 + 1 + 0 + 0 + 1 + 0 + 24 = 39
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 39 = 11

The NPI number 1750610051 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1932194172DR. KEVIN A. BLAU D.C.
Individual
Chiropractor641 LATTON LN SUITE A
PORTAGE, WI 53901
(608) 742-1300
1003003716BLAU CHIROPRACTIC SC
Organization
Chiropractor641 LATTON LN
PORTAGE, WI 53901
(608) 742-1300
1194237123 JESSICA ROSE DREDSKE DC
Individual
Chiropractor641 LATTON LN
PORTAGE, WI 53901
(608) 742-1300

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Brian David Heeren D.c. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.