Organization Active NPI

Healthy Heights: Wellness & Weight Loss Clinic LLC

  • Internal Medicine Physician
  • Trumbull, CT
National Provider Identifier
1306513015
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHY HEIGHTS: WELLNESS & WEIGHT LOSS CLINIC LLC
Practice address
100 Corporate Dr Unit B104
Trumbull, CT 06611-6346
Phone
(718) 930-7515
Fax
(713) 554-1367
NPI assigned
Aug 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Dr. Niurka J Visconti, DONPI 1205280690
Title
Physician/Owner
Phone
(718) 930-7515

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

100 Corporate Dr Unit B104
Trumbull, CT 06611-6346

Mailing address

100 Corporate Dr Unit B104
Trumbull, CT 06611-6346
Phone (718) 930-7515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211025000670 CT Part B Supplier - Clinic/Group Practice 4587052568 Receives reassigned benefits from 1 practitioner
Practice locations: Trumbull, CT

National Provider Directory

National Provider Directory

Locations

7365 Main St
#152
Stratford, CT 06614
Phone (718) 930-7515

100 Corporate Dr
Unit B104
Trumbull, CT 06611
Phone (203) 769-9133

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1306513015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE DR UNIT B104",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116346",
            "telephone_number": "718-930-7515",
            "fax_number": "713-554-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORPORATE DR UNIT B104",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116346",
            "telephone_number": "718-930-7515",
            "fax_number": "713-554-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY HEIGHTS: WELLNESS & WEIGHT LOSS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "VISCONTI",
        "authorized_official_first_name": "NIURKA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "718-930-7515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.