Kim Moriah Heneghan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016200-1 Issued in NY

Practice address

4140 27TH St
Long Island City, NY 11101-3825

Phone

(718) 784-2240

Fax

(718) 683-5757

NPI assigned

Feb 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: kim.heneghan.1@22829.direct.athenahealth.com

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.

• The Floating Hospital Inc.

  • Federally Qualified Health Center (FQHC)
  • Long Island City, NY
  • NPI 1306954631
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1447590237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 27TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013825",
            "telephone_number": "718-784-2240",
            "fax_number": "718-683-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 27TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013825",
            "telephone_number": "718-784-2240",
            "fax_number": "718-683-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEGHAN",
        "first_name": "KIM",
        "middle_name": "MORIAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016200-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Jean Heine, R.N.
• Fnu Hemant Kumar
• Lyndon Hemedes
• Pietro Fernando Henao, R.N
• Katawna Henderson
• Taina Henri
• Madeline Jane Henrie
• Samantha Henriques, RN
• Franca A Henriquez, MS-CCC-SLP
• Suhadee Henriquez

• Physician Assistant in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.