MR. NEIL CULLEN HEFFERNAN PA
NPI 1790709871
Physician Assistant - Surgical in Wilkes-barre, PA

Q: What is Neil Heffernan's NPI number?

The NPI number for Neil Heffernan is 1790709871. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Q: What is Neil Heffernan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Neil Heffernan was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 July 26, 2006PECOS Enrolled

1111 EASTEND BLVD, WILKES-BARRE, PA 18711(570) 824-3521 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Neil Cullen Heffernan Pa NPPES

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

MR. NEIL CULLEN HEFFERNAN PA (NPI 1790709871) is an individual surgical provider in Wilkes-barre, Pennsylvania, licensed in Pennsylvania (MA001791L) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790709871

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. NEIL CULLEN HEFFERNANCredential: PA

Location Address1111 EASTEND BLVDWilkes-barre, PA 18711

Mailing Address30 Farmhouse RdMountain Top, PA 18707-1725 · (570) 474-6249

Phone(570) 824-3521

Sole ProprietorYes

Enumeration DateJuly 26, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1790709871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in PA · MA001791L

1111 EASTEND BLVD, Wilkes-barre, PA 18711

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Other Identifiers 1

Medicare UPINVAD000PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Neil Cullen Heffernan Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Neil Heffernan's NPI number?

The NPI number for Neil Heffernan is 1790709871. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Neil Heffernan located?

Neil Heffernan practices at 1111 Eastend Blvd, Wilkes-Barre, PA 18711. The listed phone number is (570) 824-3521.

What is Neil Heffernan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Neil Heffernan enrolled in Medicare?

Yes. Neil Heffernan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Neil Heffernan was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.