Henny Liwan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301096524 Issued in MI

Practice address

404 Potter Blvd
Brightwaters, NY 11718

Phone

(631) 376-0055

NPI assigned

Jul 10, 2010

Last updated

Dec 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Obstetrics/Gynecology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hliwan640674@direct.unc.nchie.net
• FHIR API: https://api.platform.athenahealth.com/21288/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Carolina MG, LLC

  dba UNC Health North Carolina Heart and Vascular

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• DLP Central Carolina Medical Group LLC

  dba Central Caroling Urology

  • Urology Physician
  • Sanford, NC
  • NPI 1184163883
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Professional Services

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Triangle Women's Center PC

  • Obstetrics & Gynecology Physician
  • Morrisville, NC
  • NPI 1073840005
  Medicare reassignment NPD
• Cary Physicians Primary Care PLLC

  • Internal Medicine Physician
  • Cary, NC
  • NPI 1043028277
  NPD
• DLP Central Carolina Medical Group LLC

  dba Central Carolina Sandhills Family Care

  • Rural Health Clinic/Center
  • Broadway, NC
  • NPI 1578254215
  NPD
• DLP Central Carolina Medical Group, LLC

  dba Central Carolina Family Care

  • Family Medicine Physician
  • Sanford, NC
  • NPI 1861930968
  NPD
• NC Center for Reproductive Medicine

  • Reproductive Endocrinology Physician
  • Cary, NC
  • NPI 1861592644
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rex Hospital Inc.

  dba Rex Hospital

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1376855007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 POTTER BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 POTTER BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "11718",
            "telephone_number": "631-376-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Potter Blvd",
            "address_purpose": "LOCATION",
            "city": "Brightwaters",
            "state": "NY",
            "postal_code": "11718",
            "country_code": "US",
            "telephone_number": "631-376-0055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "781 Avent Ferry Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "NC",
            "postal_code": "275407776",
            "country_code": "US",
            "telephone_number": "919-567-6133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIWAN",
        "first_name": "HENNY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2020-00262",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301096524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hliwan640674@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "781 Avent Ferry Rd Ste 106",
            "city": "Holly Springs",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275407776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Marie Kershaw, PA-C
• Cynthia Kramer, RN
• Debra Kuhn, PH.D.
• Micaela Kuhn, LCSW
• Rebecca Kunz
• Lona Wendy Lynn-Antonucci
• Kathleen Mary Manzolillo
• Michele Maratea, LAC
• Thomas Andrew Marchese, DPT
• Stephanie Masullo

• Obstetrics & Gynecology Physician in Brightwaters, NY
• Providers in Brightwaters, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.