KEVIN J HEATON MD
NPI 1255771804
Internal Medicine in Boston, MA

NPI Status: Active since June 27, 2013

Contact Information

55 FRUIT ST.
MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA
ZIP 02114
Phone: (617) 724-6620

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  • Individual
  • Male
  • Years of Experience 13
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KEVIN HEATON

This page provides the complete NPI Profile along with additional information for Kevin Heaton, an internist established in Boston, Massachusetts with a medical specialization in Internal Medicine and more than 13 years of experience. He graduated from University Of Chicago, Pritzker School Of Medicine in 2013. The healthcare provider is registered in the NPI registry with number 1255771804 assigned on June 2013. The practitioner's primary taxonomy code is 207R00000X with license number L-255576 (MA). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1255771804
Provider Name
KEVIN J HEATON MD
Gender
Male
Entity Type
Individual
Location Address
55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL BOSTON, MA 02114
Location Phone
(617) 724-6620
Mailing Address
55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL BOSTON, MA 02114
Mailing Phone
(617) 724-6620
Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
06-27-2013
Last Update Date
06-27-2013
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An internist like Kevin Heaton is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
L-255576
License State
MA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Medicare Participation & PECOS Enrollment Status

Kevin Heaton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kevin Heaton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4587891809

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20160915000455

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    10 DME suppliers used 22 Medicare Claims 56 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    4 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    5 DME suppliers used 16 Medicare Claims 92 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    5 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    6 DME suppliers used 13 Medicare Claims 13 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    5 DME suppliers used 18 Medicare Claims 104 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    3 DME suppliers used 25 Medicare Claims 25 Services Paid

Orthotic Devices

  • DME-Orthotic Devices (DF008N)

    Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

    3 DME suppliers used 14 Medicare Claims 4000 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 16 times for 16 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 32 times for 32 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 29 times for 29 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 241 times for 241 patients

Coronavirus vaccine 13

The "Coronavirus Vaccine 13" isn't a recognized term. However, COVID-19 vaccines help protect against the virus by triggering an immune response. They teach your body how to fight the virus if exposed, reducing the risk of severe illness. It's crucial for public health and safety.

This service was performed 25 times for 25 patients

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

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.

This service was performed 78 times for 73 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 344 times for 234 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 44 times for 35 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 25 times for 25 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 30 times for 30 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

This service was performed 14 times for 14 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 432 times for 291 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 17 times for 15 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

This service was performed 17 times for 14 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

This service was performed 23 times for 23 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 26 times for 25 patients

Telephone medical discussion with physician, 21-30 minutes

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

This service was performed 44 times for 38 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $36.02 for a new patient copayment and $27.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 02114 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $144.11
  • Minimum New Patient Price $63.72
  • Maximum New Patient Price $189.86
  • Average New Patient Copayment $36.02
  • Minimum New Patient Copayment $15.93
  • Maximum New Patient Copayment $47.46

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $111.18
  • Minimum Established Patient Price $21.07
  • Maximum Established Patient Price $155.29
  • Average Established Patient Copayment $27.79
  • Minimum Established Patient Copayment $5.26
  • Maximum Established Patient Copayment $38.82

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

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kevin Heaton is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTH SHORE MEDICAL CENTER -81 HIGHLAND AVENUE
SALEM, MA 01970
(978) 741-1215Acute Care Hospitals
MASSACHUSETTS GENERAL HOSPITAL55 FRUIT STREET
BOSTON, MA 02114
(617) 724-9725Acute Care Hospitals
NEWTON-WELLESLEY HOSPITAL2014 WASHINGTON STREET
NEWTON, MA 02462
(617) 243-6000Acute Care Hospitals
BRIGHAM AND WOMEN'S HOSPITAL75 FRANCIS STREET
BOSTON, MA 02115
(617) 732-5500Acute Care Hospitals
WENTWORTH-DOUGLASS HOSPITAL789 CENTRAL AVE
DOVER, NH 03820
(603) 740-2580Acute Care Hospitals

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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.
1255771804
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22105147280
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 1 + 4 + 7 + 2 + 8 + 0 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1255771804 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063444594 HIDEO MAKIMURA M.D., PH.D.
Individual
Internal Medicine55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-7948
1821175316DR. RAFAEL MONTECINO M.D.
Individual
Surgery55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITALBIGELLOW 13.
BOSTON, MA 02114
(617) 726-3712
1184778185 JENNIFER BELMONTE PA-C
Individual
Physician Assistant55 FRUIT ST.
BOSTON, MA 02114
(617) 726-9195
1356483820MS. SUSAN ELIZABETH CAPANNO NP
Individual
Nurse Practitioner (Adult Health)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL COX 630
BOSTON, MA 02114
(617) 726-6037
1184754228 KATHERINE ANN CLAIR-HAYES LICSW, MSW
Individual
Social Worker (Clinical)55 FRUIT ST. WAC 037 MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 724-5341
1477731651DR. JAMES YOUNGHAN SONG M.D.
Individual
Radiology (Diagnostic Radiology)55 FRUIT ST.
BOSTON, MA 02114
(617) 726-7717
1215258587 ANN K WELSH M.D.
Individual
Pediatrics55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-2066
1659692937 CHRISTINA A BREZING M.D.
Individual
Psychiatry & Neurology (Psychiatry)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-2000
1083935365 DAVID T MADURAM MD, PHD
Individual
Anesthesiology55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-3030
1144541400 ALEX S KEUROGHLIAN M.D.
Individual
Psychiatry & Neurology (Psychiatry)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-2000
1225359516 FRANCISCO R AGRAIT-TABOAS M.D.
Individual
Psychiatry & Neurology (Psychiatry)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-2000
1124338546MR. BRIAN MICHAEL BACCARI PA-C
Individual
Physician Assistant55 FRUIT ST.
BOSTON, MA 02114
(617) 726-2000
1780973107 SUSIE Y HUANG MD, PHD
Individual
Radiology (Diagnostic Radiology)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 724-4255
1881983203 MARTIN J SHELLY MB BCH
Individual
Radiology (Diagnostic Radiology)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-8386
1760774228 SATISH R JAVALI MBBS
Individual
Surgery55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 724-0800
1649364738 STACY P ENGEL M.D.
Individual
Internal Medicine55 FRUIT ST. YAWKEY 4B, MGH WOMEN'S HEALTH
BOSTON, MA 02114
(617) 724-6700
1932549581 DAVID DODELL-FEDER MA
Individual
Student in an Organized Health Care Education/Training Program55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-2000
1336589985 NAM PHUONG T TRAN MD
Individual
Anesthesiology55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-3030
1003256512 QIAN YANG DMD
Individual
Oral & Maxillofacial Surgery55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(617) 726-8222
1003258732 SANJAY MENON MD
Individual
Psychiatry & Neurology (Neurology)55 FRUIT ST. MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
(857) 238-5600

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255771804, enumerated in the NPI registry as an "individual" on June 27, 2013

The provider is located at 55 Fruit St. Massachusetts General Hospital Boston, Ma 02114 and the phone number is (617) 724-6620

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 13 years of experience. He graduated from University Of Chicago, Pritzker School Of Medicine in 2013.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $144.11 with an average copayment of $36.02 for new patient appointments. Established patients should expect a typical charge of $111.18 and an average copayment of 27.79. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Adm sarscv2 30mcg trs-sucr b, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Coronavirus vaccine 13, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Fee covid-19 vac 13 res, Influenza vaccine split virus, preservative free, Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment, Insertion of needle into vein for collection of blood sample, Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and, Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a, Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report and Telephone medical discussion with physician, 21-30 minutes.

The practitioner is affiliated to the following hospital(s): NORTH SHORE MEDICAL CENTER -, MASSACHUSETTS GENERAL HOSPITAL, NEWTON-WELLESLEY HOSPITAL, BRIGHAM AND WOMEN'S HOSPITAL and WENTWORTH-DOUGLASS HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 27, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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