Individual provider Active NPI

Hylton Ivan Lightman, MD, DCH, FAAP

  • Pediatric Adolescent Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1043375728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
165455 Issued in NY
Practice address
601 Jarvis Ave
Far Rockaway, NY 11691-5425
Phone
(718) 868-4808
Fax
(718) 868-2270
NPI assigned
Dec 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 165455 NY Primary

Addresses

Primary practice location

601 Jarvis Ave
Far Rockaway, NY 11691-5425

Mailing address

601 Jarvis Ave
Far Rockaway, NY 11691-5425
Phone (718) 868-4808

Other identifiers 1

IdentifierTypeStateIssuer
01507042MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
165455NYMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Family Care of 5 Towns & Rockaway Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043375728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JARVIS AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915425",
            "telephone_number": "718-868-4808",
            "fax_number": "718-868-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JARVIS AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915425",
            "telephone_number": "718-868-4808",
            "fax_number": "718-868-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTMAN",
        "first_name": "HYLTON",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "MD, DCH, FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "165455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01507042",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.