DR. JAY A HEILMANN O.D.
NPI 1932192440
Optometrist in Milwaukee, WI

Q: What is Jay Heilmann's NPI number?

The NPI number for Jay Heilmann is 1932192440. It was assigned to this individual provider in the NPPES registry on August 30, 2005.

Q: What is Jay Heilmann's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jay Heilmann was last updated on January 16, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 30, 2005PECOS EnrolledAccepts Medicare Assignment

90.98/100

CMS Quality Rating

1684 N PROSPECT AVE, MILWAUKEE, WI 53202(414) 271-2020(414) 272-3932 Get Directions Write a Review

NPPES record last updated: January 16, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Jay A Heilmann O.d. NPPES

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

DR. JAY A HEILMANN O.D. (NPI 1932192440) is an individual optometrist in Milwaukee, Wisconsin, licensed in Wisconsin (2430) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1991).

NPPES Registry Identity

NPI1932192440

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. JAY A HEILMANNCredential: O.D.

Location Address1684 N PROSPECT AVEMilwaukee, WI 53202-2408

Mailing Address1684 N Prospect AveMilwaukee, WI 53202-2408 · (414) 271-2020 · Fax (414) 272-3932

Phone(414) 271-2020

Fax(414) 272-3932

Sole ProprietorNo

Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1991

Enumeration DateAugust 30, 2005

Last NPPES UpdateJanuary 16, 2008

✔ NPI 1932192440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in WI · 2430

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1684 N PROSPECT AVE, Milwaukee, WI 53202

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Other Identifiers 6

Medicare UPINU20630

Other4314611WI · Aetna

Medicare PIN410015883WI

Medicare PIN001602650WI

Medicaid38583100WI

Medicare PIN001368570WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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

Dr. Jay A Heilmann O.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 ID840323648

PECOS Enrollment IDI20100730000326

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 7

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, 30-39 minutes 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.

752 services729 patients

Established patient office or other outpatient visit, 20-29 minutes 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.

314 services240 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

89 services85 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

72 services72 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

68 services66 patients

New patient office or other outpatient visit, 45-59 minutes 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.

44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53202 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

90.98/100

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

Individually scored

Quality

81.96

Improvement Activities

Reported Quality Measures

Diabetes: Eye Exam

100%271 patients5/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

99%4,899 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

59%2,424 patients3/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

100%166 patients

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 2,533 patients

Patients totalRate: 0% · 2,533 patients

0%2,533 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier25 claims25 services$57.26 avg. paid by Medicare

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2103

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier12 claims19 services$32.33 avg. paid by Medicare

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

Other Providers at the Same Location NPPES 12

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

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