NPIMap

Organization Active NPI

Heritage New York Medical PC

  • Internal Medicine Physician
  • Garden City, NY
National Provider Identifier
1578982146
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HERITAGE NEW YORK MEDICAL PC
Practice address
501 Franklin Ave
Ste. 140
Garden City, NY 11530-5807
Phone
(516) 531-2001
NPI assigned
Apr 10, 2014
Last updated
Nov 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Mary Kathleen Nix, RNNPI 1821347774
Title
Ceo
Phone
(516) 531-2107

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 11-3284153 NY
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

501 Franklin Ave
Ste. 140
Garden City, NY 11530-5807

Mailing address

501 Franklin Ave
Ste. 140
Garden City, NY 11530-5807
Phone (516) 531-2001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140804002243 NY Part B Supplier - Clinic/Group Practice 5991922643 Receives reassigned benefits from 11 practitioners
Practice locations: Garden City, NY

National Provider Directory

National Provider Directory

Locations

501 Franklin Ave
Ste 140
Garden City, NY 11530
Phone (516) 267-5541

501 Franklin Ave
Ste 300
Garden City, NY 11530
Phone (516) 515-8803

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1578982146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FRANKLIN AVE",
            "address_2": "STE. 140",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305807",
            "telephone_number": "516-531-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FRANKLIN AVE",
            "address_2": "STE. 140",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305807",
            "telephone_number": "516-531-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE NEW YORK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "NIX",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-531-2107",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NY",
            "license": "11-3284153",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.