Individual provider Active NPI

Lisa A. Honkanen, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • East Northport, NY
National Provider Identifier
1811959372
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
211497 Issued in NY
Practice address
120 Daly Rd
East Northport, NY 11731-6308
Phone
(631) 499-1236
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060426000916 NY Practitioner - Geriatric Medicine 5496765000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa a. Honkanen, M.D., P.C. Geriatric Medicine CurrentSince Sep 18, 2006 Accepting new patients
Weill Medical College of Cornell Geriatric Medicine Past Accepting new patients

Locations

555 Albany Ave
Amityville, NY 11701
Phone (361) 841-7300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1811959372",
    "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": {
        "last_name": "HONKANEN",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_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

Verify at the official NPI Registry.