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DR. ILYSSA A HENLE M.D.
NPI 1346479003
Pediatrics in Bronx, NY

Active since July 02, 2009PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 920-4321 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Ilyssa A Henle M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ILYSSA A HENLE M.D. (NPI 1346479003) is an individual pediatrics provider in Bronx, New York, licensed in New York (262271) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346479003
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. ILYSSA A HENLECredential: M.D.
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 920-4321
Phone(718) 920-4321
Sole ProprietorYes
Enumeration DateJuly 2, 2009
Last NPPES UpdateJuly 21, 2026
NPPES CertifiedJuly 21, 2026
✔ NPI 1346479003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 262271
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
111 E 210TH ST, Bronx, NY 10467
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Other Names 1

Former Name (1)Dr. Ilyssa A Goodman M.d.

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ilyssa A Henle M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Ilyssa Henle reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Boston Children's Health Physicians, LLP
15 mi
Pediatrics
19 SKYLINE DR OFC 1N-D06
Hawthorne, NY 10532
  • Reassigned Medicare billing, New York enrollment
  • 511 clinicians in this Medicare group
NPI 1467454967 (914) 594-2100
New York University
1,049 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10467 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AMANDA MCNEAR JACOBS M.D.
Pediatrics (Adolescent Medicine)
111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467
Bronx County (718) 920-2306
HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ilyssa Henle's NPI number?

The NPI number for Ilyssa Henle is 1346479003. It was assigned to this individual provider in the NPPES registry on July 2, 2009. The provider is also known as Dr. Ilyssa A Goodman M.D..

Where is Ilyssa Henle located?

Ilyssa Henle practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4321.

What is Ilyssa Henle's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Ilyssa Henle enrolled in Medicare?

Yes. Ilyssa Henle is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ilyssa Henle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ilyssa Henle reassigns Medicare benefits to 2 organizations: Boston Children's Health Physicians, LLP (Hawthorne, NY) and New York University (Boynton Beach, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ilyssa Henle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ilyssa Henle was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.