Organization Active NPI

Lisa a. Honkanen, M.D., P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • East Northport, NY
National Provider Identifier
1801983044
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
211497 Issued in NY
Legal business name
LISA A. HONKANEN, M.D., P.C.
Practice address
120 Daly Rd
East Northport, NY 11731-6308
Phone
(631) 499-1236
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lisa A. Honkanen, M.D.NPI 1811959372
Title
President
Phone
(631) 499-1236

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 211497 NY Primary

Addresses

Primary practice location

120 Daly Rd
East Northport, NY 11731-6308

Mailing address

120 Daly Rd
East Northport, NY 11731-6308
Phone (631) 499-1236

Other identifiers 1

IdentifierTypeStateIssuer
02256086MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070727000527 NY Part B Supplier - Clinic/Group Practice 0244331726 Receives reassigned benefits from 1 practitioner
Practice locations: East Northport, NY

National Provider Directory

National Provider Directory

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": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801983044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DALY RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117316308",
            "telephone_number": "631-499-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DALY RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117316308",
            "telephone_number": "631-499-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A. HONKANEN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HONKANEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-499-1236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "211497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02256086",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.