Individual provider Active NPI

Alycia Paige Heiner, DO

  • Student in an Organized Health Care Education/Training Program
  • Washington, DC
National Provider Identifier
1417578733
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Parkside Health Center
765 Kenilworth Terrace NE
Washington, DC 20019
Phone
(202) 388-8183
Fax
(202) 548-8600
NPI assigned
Apr 27, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

Parkside Health Center
765 Kenilworth Terrace NE
Washington, DC 20019

Mailing address

501 S Washington Ave
Scranton, PA 18505-3814
Phone (570) 343-2383

Other names 1

  • Dr. Alycia Paige Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260406003734 DC Practitioner - HospitalistPractitioner - Pediatric Medicine 8123432564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pediatric Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8095 Innovation Park Dr
Fairfax, VA 22031-4868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1417578733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S WASHINGTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053814",
            "telephone_number": "570-343-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARKSIDE HEALTH CENTER",
            "address_2": "765 KENILWORTH TERRACE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20019",
            "telephone_number": "202-388-8183",
            "fax_number": "202-548-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINER",
        "first_name": "ALYCIA",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYCIA",
            "last_name": "LEE",
            "middle_name": "PAIGE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.