Organization Active NPI

Hydro Heal LLC

  • Psychiatry Physician
  • Waltham, MA
National Provider Identifier
1811761364
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HYDRO HEAL LLC
Practice address
273 Ridge LN Apt 308
Waltham, MA 02452-4990
Phone
(857) 316-8020
NPI assigned
Nov 14, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Pearl Alweny, NPNPI 1255830543
Title
Ceo
Phone
(857) 316-8020

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
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

273 Ridge LN Apt 308
Waltham, MA 02452-4990

Mailing address

PO Box 541378
Waltham, MA 02454-1378
Phone (857) 316-8020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240103001879 MA Part B Supplier - Clinic/Group Practice 1951751908 Receives reassigned benefits from 1 practitioner
Practice locations: Waltham, MA

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1811761364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541378",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024541378",
            "telephone_number": "857-316-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 RIDGE LN APT 308",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524990",
            "telephone_number": "857-316-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRO HEAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "ALWENY",
        "authorized_official_first_name": "PEARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "857-316-8020",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.