MEDICARE: DR. NATHAN PETER HEILMAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2982-35	WI
2	152W00000X	Optometrist	046-009596	IL
3	152W00000X	Optometrist	4618	MA
4	152WC0802X	Corneal and Contact Management Optometrist	3198	MN
5	152W00000X	Optometrist	3198	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053390385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN PETER HEILMAN O.D.

Provider Business Mailing Address
First Line	:	2019 JEFFERSON RD
Second Line	:	STE A
City	:	NORTHFIELD
State	:	MN
Zip	:	55057-3258
Country	:	US
Telephone Number	:	507-645-9202
Fax Number	:	507-645-9203

Provider Business Practice Location Address
First Line	:	2019 JEFFERSON RD STE A
Second Line	:
City	:	NORTHFIELD
State	:	MN
Zip	:	55057-3258
Country	:	US
Telephone Number	:	507-645-9202
Fax Number	:	507-645-9203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	05/07/2024

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