Organization Active NPI

Healthy Kids Pediatrics PLLC

  • Pediatrics Physician
  • Port Washington, NY
National Provider Identifier
1922282300
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HEALTHY KIDS PEDIATRICS PLLC
Practice address
211 Main St
Port Washington, NY 11050
Phone
(516) 944-8555
Fax
(516) 944-0387
NPI assigned
Dec 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Cynthia Lynn Seltzer
Title
RN Office Manger
Phone
(516) 944-8555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

211 Main St
Port Washington, NY 11050

Mailing address

211 Main St
Port Washington, NY 11050-3240
Phone (516) 944-8555

Other practice location 1

6 Bernard St
Port Washington, NY 11050-2902
Phone (516) 944-8555

Other identifiers 3

IdentifierTypeStateIssuer
1538129895MedicaidNY
1710921622MedicaidNY
1093776676MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0143778Healthy Kids Pediatrics PLLC211 Main Street, Port Washington, NY 11050Certificate of waiverJun 15, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1922282300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503240",
            "telephone_number": "516-944-8555",
            "fax_number": "516-944-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "11050",
            "telephone_number": "516-944-8555",
            "fax_number": "516-944-0387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Bernard St",
            "address_purpose": "LOCATION",
            "city": "Port Washington",
            "state": "NY",
            "postal_code": "110502902",
            "country_code": "US",
            "telephone_number": "516-944-8555",
            "fax_number": "516-944-0387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHY KIDS PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "SELTZER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "RN OFFICE MANGER",
        "authorized_official_telephone_number": "516-944-8555"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538129895",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710921622",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093776676",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.