Advanced Home Wound Healing & Wellness LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ADVANCED HOME WOUND HEALING & WELLNESS LLC

Practice address

357 Swinnerton St
Staten Island, NY 10307-1644

Phone

(609) 442-6803

NPI assigned

Jun 3, 2026

Last updated

Jun 23, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dimyana Ata, PA-CNPI 1992369458

Title

Owner

Phone

(973) 489-9615

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Dimyana S Ata, PA-C

  • Physician Assistant
  • Egg Harbor Township, NJ
  • NPI 1992369458
  Authorized official Same address or phone
• Wislande Fleurissant

  • Family Nurse Practitioner
  • West Orange, NJ
  • NPI 1295447027
  NPD

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1265365050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 SWINNERTON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071644",
            "telephone_number": "609-442-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 SWINNERTON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071644",
            "telephone_number": "609-442-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HOME WOUND HEALING & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "ATA",
        "authorized_official_first_name": "DIMYANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-489-9615",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.