Individual provider Active NPI

Heather Hyon, PA-C

  • Physician Assistant
  • Hoboken, NJ
National Provider Identifier
1508454703
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00805200 Issued in NJ
Practice address
1425 Bloomfield St
Hoboken, NJ 07030-5505
Phone
(201) 706-8490
NPI assigned
Jan 4, 2021
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00805200 NJ Primary

Addresses

Primary practice location

1425 Bloomfield St
Hoboken, NJ 07030-5505

Mailing address

900 Ave at Port Imperial Blvd Apt 521
Weehawken, NJ 07086-6104
Phone (856) 313-0426

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240118002311 NJ Practitioner - Physician Assistant 9830507896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

506 Broadway
Bayonne, NJ 07002-3712
Phone (201) 471-7012

935 River Rd
Suite 301
Edgewater, NJ 07020-2233
Phone (201) 471-7012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00805200NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Jan 1, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Jan 1, 2024 Accepting new patients
Riverside Medical Group Past Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

1 Harmon Plz
Fl 10
Secaucus, NJ 07094
Phone (201) 636-7233

Interoperability endpoints

  • Direct secure messaging: hhyon104431@direct.optum.com

Organizations & group practices 4

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1508454703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AVE AT PORT IMPERIAL BLVD APT 521",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866104",
            "telephone_number": "856-313-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BLOOMFIELD ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305505",
            "telephone_number": "201-706-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYON",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00805200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.