Organization Active NPI

Healthy Way Medical PC

  • Internal Medicine Physician
  • Hicksville, NY
National Provider Identifier
1508142373
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHY WAY MEDICAL PC
Practice address
349 W Old Country Rd
Hicksville, NY 11801-4107
Phone
(347) 510-5421
NPI assigned
Oct 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Lisa PersaudNPI 1124351093
Title
President
Phone
(347) 510-5421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

349 W Old Country Rd
Hicksville, NY 11801-4107

Mailing address

200 Covert Ave
Floral Park, NY 11001-3741
Phone (347) 510-5421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120305000434 NY Part B Supplier - Clinic/Group Practice 7618136045 Receives reassigned benefits from 1 practitioner
Practice locations: Hicksville, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2278818Healthy Way Medical PC349 West Old Country Road, Hicksville, NY 11801Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory

Locations

10825 63rd Ave
Forest Hills, NY 11375
Phone (718) 406-7744

349 W Old Country Rd
Hicksville, NY 11801
Phone (347) 510-5421

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/cybermed_healthyway

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1508142373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COVERT AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013741",
            "telephone_number": "347-510-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 W OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014107",
            "telephone_number": "347-510-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY WAY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-510-5421"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.