Individual provider Active NPI

Amy Lee Heimink, RN MSN ANP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1225121106
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
301949 Issued in NY
Practice address
One Penn Plaza 8TH Floor
Optum
New York, NY 10119-0002
Phone
(646) 438-5314
Fax
(888) 291-2617
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 301949 NY Primary

Addresses

Primary practice location

One Penn Plaza 8TH Floor
Optum
New York, NY 10119-0002

Mailing address

One Penn Plaza 8TH Floor
Optum
New York, NY 10119-0002
Phone (646) 438-5314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171012001194 NY Order and Referring Only - Nurse Practitioner 6709870165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
301949NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Run Healthcare Physicians LLP Past Accepting new patients

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1225121106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE PENN PLAZA 8TH FLOOR",
            "address_2": "OPTUM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "646-438-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE PENN PLAZA 8TH FLOOR",
            "address_2": "OPTUM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "646-438-5314",
            "fax_number": "888-291-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMINK",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "RN MSN ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.