Organization Active NPI

Larchmont Family Medicine, PLLC

  • Family Medicine Physician
  • Larchmont, NY
National Provider Identifier
1124487087
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LARCHMONT FAMILY MEDICINE, PLLC
Practice address
1890 Palmer Ave
Suite 304
Larchmont, NY 10538-3059
Phone
(914) 834-9606
Fax
(914) 834-0648
NPI assigned
Feb 19, 2016
Last updated
Feb 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Authorized official

Name
Philip Heinegg, M.D.NPI 1588678593
Title
Owner
Phone
(914) 834-9606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1890 Palmer Ave
Suite 304
Larchmont, NY 10538-3059

Mailing address

1890 Palmer Ave
Suite 304
Larchmont, NY 10538-3059
Phone (914) 834-9606

Other identifiers 3

IdentifierTypeStateIssuer
1629079249OtherNYNPI
1952448862OtherNYNPI
1588678593OtherNYNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160720001019 NY Part B Supplier - Clinic/Group Practice 3274826813 Receives reassigned benefits from 3 practitioners
Practice locations: Larchmont, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0138069Larchmont Family Medicine PLLC1890 Palmer Ave Ste 304, Larchmont, NY 10538Provider-performed microscopyMar 31, 2028

National Provider Directory

National Provider Directory

Locations

1890 Palmer Ave
Ste 304
Larchmont, NY 10538
Phone (914) 834-4123

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1124487087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 PALMER AVE",
            "address_2": "SUITE 304",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105383059",
            "telephone_number": "914-834-9606",
            "fax_number": "914-834-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 PALMER AVE",
            "address_2": "SUITE 304",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105383059",
            "telephone_number": "914-834-9606",
            "fax_number": "914-834-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARCHMONT FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "HEINEGG",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-834-9606",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629079249",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952448862",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588678593",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.