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Active NPI 1649243643 Individual Practitioner Male Practitioner

Dr. John Philip Heffernan , MD

Urology • Newport, RI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. John Heffernan, MD is a certified Urology practicing in Newport, RI. With approximately 40 years of clinical experience since graduating from Georgetown University School Of Medicine in 1986, Dr. Heffernan delivers high-quality medical care to the local community at 38 POWEL AVE.

Dr. Heffernan is affiliated with Silver Spring Health Care Management Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, automated urinalysis test, ultrasound measurement of bladder capacity after voiding. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

38 Powel Ave

Newport, RI 028402655

Telephone 4018472418
Fax 4016191028

Medicare Profile & Education

Medical School

Georgetown University School Of Medicine

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Newport, RI

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
40 Yrs +11.4 yrs vs City Avg
City Avg: 28.6 Yrs
State Avg: 25.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Newport, RI (71 Statewide)

Telehealth Adoption Rate
83.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
60.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Heffernan (40 Years) 40 Yrs
Newport Specialty Average (28.6 Years) 28.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
542 486 $195.29 $91.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
534 416 $277.90 $128.05
81003 Automated urinalysis test
502 435 $4.26 $2.19
51798 Ultrasound measurement of bladder capacity after voiding
236 214 $24.37 $11.41
52000 Diagnostic exam of bladder and urethra using an endoscope
111 88 $530.05 $240.61
51703 Complicated insertion of bladder tube
87 28 $328.28 $150.37
J9217 Leuprolide acetate (for depot suspension), 7.5 mg
85 18 $441.00 $178.75
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
78 78 $359.05 $167.46
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
78 11 $31.74 $14.47
51702 Simple insertion of temporary bladder tube
58 23 $137.26 $62.82
99231 Follow-up hospital inpatient care per day, typically 15 minutes
55 37 $106.00 $47.75
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
54 48 $50.89 $23.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
50 48 $279.64 $129.12
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
43 32 $170.42 $76.13
99442 Telephone medical discussion with physician, 11-20 minutes
33 31 $196.55 $91.32
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle
25 19 $74.80 $35.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
25 25 $242.64 $111.82
52332 Insertion of stent in urinary duct (ureter) using an endoscope
20 18 $889.00 $145.05
51701 Insertion of temporary bladder tube
15 11 $97.33 $44.59
76872 Ultrasound scan of pelvic region through rectum
15 15 $69.07 $32.23
52356 Crushing of stone of ureter with insertion of stent using an endoscope
12 12 $880.33 $402.05
55700 Biopsy of prostate gland
12 12 $528.00 $128.44

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License RI MD09513

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
7006003 (RI)

Hospital & Practice Group Affiliations

Silver Spring Health Care Management Inc

70 Kenyon Ave, Wakefield, RI 028794253

Phone: 4017888780

Silver Spring Health Care Management Inc

38 Powel Ave, Newport, RI 028402655

Phone: 4017888780

Silver Spring Health Care Management Inc

3461 S County Trl, East Greenwich, RI 028181463

Phone: 4017888780

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1154394096

Doctor of Medicine (M.D.)

NPI 1215900758

Doctor of Medicine (M.D.)

NPI 1457324758

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 25, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location January 25, 2010

Registered at 38 POWEL AVE, NEWPORT, RI 028402655 (Tel: 4018472418)

📍
Updated Business Mailing Address January 25, 2010

Registered at 38 POWEL AVE, NEWPORT, RI 028402655 (Tel: 4018472418)

👤
Provider Name / Credentials Updated January 25, 2010

Recorded as JOHN HEFFERNAN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2010

Urology (License #MD09513 in RI)

🟢
Initial NPI Registration & Enumeration February 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649243643
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 09, 2006
Last Update: January 25, 2010
Sole Proprietor: Yes

Mailing Address

38 Powel Ave

Newport, RI 028402655

Phone: 4018472418

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.