Individual provider Active NPI

Michele Hein, PA-C

  • Medical Physician Assistant
  • Hauppauge, NY
National Provider Identifier
1114547791
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006711 Issued in NY
Practice address
700 Veterans Memorial Hwy
Hauppauge, NY 11788-2952
Phone
(516) 220-7911
NPI assigned
Apr 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00266700 NJ
Medical Physician Assistant 363AM0700X 006711 NY Primary

Addresses

Primary practice location

700 Veterans Memorial Hwy
Hauppauge, NY 11788-2952

Mailing address

107 Demarest Rd
Bloomingdale, NJ 07403-1404
Phone (516) 220-7911

Other practice location 1

1 Pond Path
Smithtown, NY 11787-1815
Phone (516) 220-7911

Other practice location 2

200A Montauk Hwy
West Sayville, NY 11796-1804
Phone (516) 220-7911

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

State licenses

LicenseStateTypeSpecialty
25MP00266700NJMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1114547791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DEMAREST RD",
            "city": "BLOOMINGDALE",
            "state": "NJ",
            "postal_code": "074031404",
            "telephone_number": "516-220-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 VETERANS MEMORIAL HWY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882952",
            "telephone_number": "516-220-7911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Pond Path",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117871815",
            "country_code": "US",
            "telephone_number": "516-220-7911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200A Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Sayville",
            "state": "NY",
            "postal_code": "117961804",
            "country_code": "US",
            "telephone_number": "516-220-7911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIN",
        "first_name": "MICHELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00266700",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.