Henny Liwan, M.D.

Key facts

NPI

1376855007

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

License

4301096524 (MI)

Practice address

404 Potter Blvd
Brightwaters, NY 11718

Phone

(631) 376-0055

NPI assigned

Jul 10, 2010

Sex

Female

Sole proprietor

No

Organizations & group practices 9

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.

• North Carolina MG, LLC Hospitalist Physician · Raleigh, NC · NPI 1215741640
  Medicare reassignment Care Compare group NPD NC · OBSTETRICS & GYNECOLOGY
• DLP Central Carolina Medical Group LLC Urology Physician · Sanford, NC · NPI 1184163883
  Medicare reassignment NPD NC
• Lakeview Medical Center Inc of Rice Lake Clinic/Center · Rice Lake, WI · NPI 1093201832
  Medicare reassignment NPD WI
• Marshfield Clinic Inc Clinic/Center · Marshfield, WI · NPI 1952347981
  Medicare reassignment NPD WI
• Triangle Women'S Center PC Obstetrics & Gynecology Physician · Morrisville, NC · NPI 1073840005
  Medicare reassignment NPD NC · OBSTETRICS & GYNECOLOGY
• Cary Physicians Primary Care PLLC Internal Medicine Physician · Cary, NC · NPI 1043028277
  NPD
• DLP Central Carolina Medical Group LLC Rural Health Clinic/Center · Broadway, NC · NPI 1578254215
  NPD
• DLP Central Carolina Medical Group, LLC Family Medicine Physician · Sanford, NC · NPI 1861930968
  NPD
• NC Center for Reproductive Medicine Reproductive Endocrinology Physician · Cary, NC · NPI 1861592644
  NPD (past)

Hospital & facility affiliations 1

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

• Rex Hospital Inc. General Acute Care Hospital · Raleigh, NC · NPI 1497797088
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Obstetrics/Gynecology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Carolina MG LLC (723 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital · Raleigh, NC · CCN 340114

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in WI, NC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 22, 2022.

{
    "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": []
}

Other providers in Brightwaters, NY

• 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

All providers in Brightwaters, NY · Obstetrics & Gynecology Physician in New York