NPI registry status
Active
2026 NPPES data Urology Physician NPI 1649243643 M.D.
Verify on CMS → John Heffernan, M.D.
Urology Physician in Newport, Rhode Island.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 13,606 in Urology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
5K
Medicare Part D claims · 1K beneficiaries · Urology Physician avg: 1K
Industry payments
$1.3K
50 payments · CMS Open Payments (Sunshine Act)
What the federal data shows
John Heffernan, M.D. filed 4,999 Medicare Part D claims in 2024 as a Urology Physician in Newport, Rhode Island.
- 5K
- Part D claims, 2024
- Likely
- board-certified (heuristic)
- ≥93rd
- pct by Part D claim volume (lower-bound band)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Federal trust snapshot
What official records show about John Heffernan, M.D.
Federal records show an active NPI with Medicare Part D prescribing activity — verifiable registry data, not a proprietary rating.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1649243643), first enumerated 02/09/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 4,999 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$1.3K in reported industry payments (50 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1649243643 · Urology Physician
NPI-10 · ENUM-LEGACY · TAX-MID · RX-MID · BOOK-THIN · PHOTO-ENUM
- NPI-10 1649243643
- ENUM-LEGACY 2006
- TAX-MID 14K Urology Physician
- RX-MID 4,999
- BOOK-THIN 59 in Rhode Island
- PHOTO-ENUM Joseph Copulsky · 2006
John Heffernan, M.D.'s Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2024, across all CMS prescribers nationally
4,999 ≥ 93rd percentile 93% of 1,416,883 prescribers are in lower value bands
Each bar is a band; taller bars hold more prescribers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
The percentile is a conservative 100-claim band: it counts only prescribers in lower claim-volume bands. Medicare Part D claim volume is activity context, not a quality measure or recommendation. See methodology § corpus placement.
Source CMS Medicare Part D Prescriber Public Use File · 2024
✓
Board certification likely (heuristic, not verified)
John Heffernan, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about John Heffernan, M.D.?
Quality data not reportedPrimary specialty
Urology Physician
Medicare Part D claims
4,999 269% vs specialty avg
Specialty distribution in Rhode Island
How Urology Physician compares to other specialties among Rhode Island providers
Board certification
Not published by CMS
CMS does not publish a per-provider board-certification field in NPPES. PlainDoctor does not have a reliable per-specialty certification rate to show for Urology Physician. Verify directly:
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Practice Address
Provider Details
| NPI | 1649243643 |
|---|---|
| Specialty | Urology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 02/09/2006 |
Hospital and facility affiliations
Facilities where John Heffernan, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Silver Spring Health Care Management Inc
East Greenwich, RI
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for John Heffernan, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$1.3K
Largest payer
C. R. Bard, Inc. & Subsidiaries
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2024.
4,999
Total Claims
$1.3M
Total Drug Cost
1,037
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 9,368.833
- Total Day Supply
- 265,268
- Generic Drug Cost
- $114K
- Opioid Claims
- 129 (2.6% rate)
- Antibiotic Claims
- 678
Patient Demographics
- Average Patient Age
- 76.4 years
- Avg HCC Risk Score
- 1.24
- Gender Split
- 25% female / 75% male
- Age Distribution
- <65: 49, 65-74: 371, 75-84: 440, 85+: 177
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What John Heffernan, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2024
- Finasteride
Finasteride
1,034 claims
- Tamsulosin Hcl
Tamsulosin Hcl
1,025 claims
- Methenamine Hippur… 341
Methenamine Hippurate
341 claims
- Gemtesa 217
Gemtesa
217 claims
- Testosterone Cypio… 192
Testosterone Cypionate
192 claims
- Myrbetriq 179
Myrbetriq
179 claims
- Cephalexin 175
Cephalexin
175 claims
- Sulfamethoxazole-T… 126
Sulfamethoxazole-Trimethoprim
126 claims
| Drug | Claims |
|---|---|
| Finasteride | 1,034 |
| Tamsulosin Hcl | 1,025 |
| Methenamine Hippurate | 341 |
| Gemtesa Vibegron | 217 |
| Testosterone Cypionate | 192 |
| Myrbetriq Mirabegron | 179 |
| Cephalexin | 175 |
| Sulfamethoxazole-Trimethoprim Sulfamethoxazole/Trimethoprim | 126 |
| Ciprofloxacin Hcl | 117 |
| Potassium Citrate Er Potassium Citrate | 102 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Urology Physician Overview
How John Heffernan, M.D. fits within the Urology Physician landscape nationally.
13,606
Urology Physician Providers in US
54
States with Urology Physician
1,354
Avg Claims per Provider
John Heffernan, M.D.'s 4,999 claims are above the specialty average of 1,354.
Nationwide Urology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Heffernan, both outside Rhode Island so the neighborhoods are not geographic containment.
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Urology Physician Providers in Rhode Island
Other clinicians with the same primary specialty enrolled in Rhode Island, drawn from the same CMS NPPES roster as Heffernan.
One of 59 Urology Physician providers enrolled in Rhode Island, 5 are shown here.
Dr. Shadi Al Ekish
M.D.
Providence, RI
Dr. Michael Alavian
M.D.
Johnston, RI
Dr. Ashley Alford
MD
Newport, RI
Dr. Mariepet Ask
M.D.
Providence, RI
Dr. Lawrence Audino
M.D.
Portsmouth, RI
Compare Urology Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is John Heffernan, M.D.'s specialty? ▼
John Heffernan, M.D. specializes in Urology Physician and practices in Newport, Rhode Island. Credentials: M.D..
How much does John Heffernan, M.D. prescribe under Medicare Part D? ▼
In 2024, John Heffernan, M.D. wrote 4,999 Medicare Part D claims totaling $1.3M in drug costs for 1,037 beneficiaries.
Where is John Heffernan, M.D. located? ▼
John Heffernan, M.D. is located at 38 POWEL AVE, Newport, RI, 02840. Phone: (401) 847-2418.
What is John Heffernan, M.D.'s NPI number? ▼
John Heffernan, M.D.'s National Provider Identifier (NPI) is 1649243643, issued on 02/09/2006.
Does John Heffernan, M.D. prescribe opioids? ▼
Yes, John Heffernan, M.D. had 129 opioid claims in 2024 with an opioid prescribing rate of 2.6%.
How many Urology Physician providers are there in the US? ▼
There are 13,606 Urology Physician providers across 54 states in the US. The average Urology Physician provider writes 1,354 Medicare Part D claims per year.
What drugs does John Heffernan, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, John Heffernan, M.D.'s most frequently prescribed drugs include Finasteride, Tamsulosin Hcl, Methenamine Hippurate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does John Heffernan, M.D. accept Medicare? ▼
John Heffernan, M.D. appears in CMS Medicare data with 4,999 Part D claims and 1,037 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify John Heffernan, M.D.'s credentials? ▼
John Heffernan, M.D.'s NPI is 1649243643 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2024). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of August 2026 (NPPES) / 2024 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.