James Heaberlin, M.D.
NPI 1043604960 · Orthopaedic Hand Surgery Physician · Wauwatosa, WI
Enrolled with Medicare as Practitioner - Orthopedic Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
James Heaberlin, M.D. is a Orthopaedic Hand Surgery Physician provider in Wauwatosa, WI (NPI 1043604960).
Provider details
- NPI number
- 1043604960
- Entity type
- Individual
- Primary specialty
- Orthopaedic Hand Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 75451 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
11 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
3 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
346 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 146 | $84 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 84 | $101 |
| Injection Into Tendon Or Ligament20550 | 47 | $51 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 26 | $117 |
| Aspiration And/Or Injection of Fluid From Small Joint20600 | 23 | $51 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 15 | 13 |
| Acetaminophen With Codeinebrand: Acetaminophen-Codeine | 14 | 13 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (2)
- 1740 W Taylor StChicago, IL 60612-7232Phone: (866) 600-2273
- 2900 W Oklahoma AveMilwaukee, WI 53215-4330Phone: (414) 649-6000
Registry dates
- Enumerated
- 2015-03-28
- Last updated
- 2024-08-12
- Certified
- 2024-08-12
Frequently asked questions
- What is James Heaberlin's NPI number?
- James Heaberlin's National Provider Identifier (NPI) is 1043604960, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is James Heaberlin's specialty?
- James Heaberlin is listed in the NPPES registry with a primary specialty of Orthopaedic Hand Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is James Heaberlin located?
- James Heaberlin's practice location on file with NPPES is 2999 N Mayfair Rd, Wauwatosa, WI 53222-4306.
- What is James Heaberlin's phone number?
- The practice phone number listed in the NPPES registry for James Heaberlin is (414) 479-7000.
- Does James Heaberlin accept Medicare?
- James Heaberlin is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is James Heaberlin's NPI active?
- Yes — James Heaberlin's NPI (1043604960) is active in the NPPES registry as of the last update on 2024-08-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.