Individual provider Active NPI

Carlos Enrique Huauya Leuyacc, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1487273660
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324906-01 Issued in NY
Practice address
435 Fort Washington Ave Apt 1C
New York, NY 10033-3527
Phone
(212) 923-0408
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 324906-01 NY Primary

Addresses

Primary practice location

435 Fort Washington Ave Apt 1C
New York, NY 10033-3527

Mailing address

12 Golf Rd
Bloomfield, NJ 07003-3119
Phone (201) 823-7425

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002306 NY Practitioner - Internal Medicine 2062801590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jose a Goris MD PCGroup PAC ID 3870761745, 4 clinicians

Practice addresses (Care Compare)

435 Fort Washington Ave
Apt 1C
New York, NY 10033-3527
Phone (212) 923-0408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324906NYMDLicensed Practical Nurse
324906-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jose a Goris, MD PC CurrentSince Aug 1, 2023 Accepting new patients
La Fe Pharmacy Corp. PastSince Aug 1, 2023 Accepting new patients

Locations

4220 Broadway
New York, NY 10033
Phone (212) 321-0083

435 Fort Washington Ave
Apt 1C
New York, NY 10033
Phone (212) 434-3420

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DAHHAA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1487273660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GOLF RD",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033119",
            "telephone_number": "201-823-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 FORT WASHINGTON AVE APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333527",
            "telephone_number": "212-923-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUAUYA LEUYACC",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "324906-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.