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Network VAPT for a Healthcare Provider

Network Penetration Test for a healthcare client. Real engagement by an ISO/IEC 27001:2022 certified team with measurable outcomes.

Case Study Industry-Standard Methodology Real Client Outcome
42
VULNERABILITIES
100%
CRITICAL/HIGH FIXED
2 weeks
DELIVERY
0
CRITICAL AT SIGN-OFF

At a Glance

  • Industry: Healthcare
  • Engagement type: Internal + External Network VAPT
  • Tech stack: Active Directory forest, Epic-based EHR, PACS imaging, vendor IoMT devices, on-premise data centers, VPN remote access, Cisco network infrastructure
  • Outcome: All critical and high-severity findings remediated and re-tested with no critical issues remaining at close.
  • Delivered by: ISO/IEC 27001:2022 certified consultants with OSCP, OSEP, CISA, CISM credentials.

Compliance Frameworks Satisfied

HIPAA Security Rule DPDP Act ISO 27001:2022 NIST SP 800-115 PTES HITRUST CSF

Client Overview

Industry: Healthcare

Product: Multi-hospital network covering EHR, lab systems, imaging and IoMT devices

Tech stack: Active Directory forest, Epic-based EHR, PACS imaging, vendor IoMT devices, on-premise data centers, VPN remote access, Cisco network infrastructure

The client operates 3 multi-specialty hospitals across South India with ~1,400 beds combined, processing PHI for 80,000+ active patients. Recent ransomware attacks on peer Indian hospitals had elevated security priority at the board level.

Challenge

Three factors drove the urgency of this engagement:

  • Ransomware peer impact. Two regional hospitals had been hit with ransomware in the prior 6 months, with ICU operations disrupted
  • HIPAA + DPDP audit requirements. US insurance partnerships required HIPAA evidence; new DPDP Act 2023 added Indian patient data obligations
  • Medical device proliferation. 600+ IoMT devices (infusion pumps, monitors, imaging) on hospital networks with unknown security posture

Our Approach

Codesecure delivered a structured engagement combining automated coverage with deep manual testing focused on the specific risk areas for this client.

1
Day 1-2
Scoping & NDA
2
Day 3-4
Threat Model
3
Day 5-12
Active Testing
4
Day 13-14
Reporting
5
+30 Days
Free Retest

Scope of Testing

The engagement covered the following primary areas:

  • External perimeter testing of internet-facing services (VPN, mail gateway, patient portal)
  • Internal network testing from assumed-breach perspective via deployed pentest VM
  • Active Directory enumeration and attack-path analysis using BloodHound
  • Medical device network segmentation testing aligned with IEC 62443
  • EHR access control and audit log integrity review
  • Wireless network testing including guest network isolation
  • Vendor remote access and third-party VPN security review

// Tooling Used

Nmap Nessus BloodHound CrackMapExec Impacket Responder Cobalt Strike Mimikatz Wireshark

Reporting & Walkthrough

Executive summary delivered alongside a technical report containing reproducible PoC steps, CVSS v3.1 severity scoring and developer-actionable remediation guidance. Live walkthrough with the client team covered every critical finding with reproduction and recommended fix path.

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Results

Critical Findings

  • Domain Admin compromise achievable in under 4 hours from any workstation via Kerberoasting + AS-REP roasting
  • Medical device VLAN reachable from corporate workstations with no enforcement, enabling potential infusion pump access
  • EHR backend database accessible via SQL injection in legacy reporting module, exposing complete patient PHI

High & Medium Severity

Unconstrained Kerberos delegation on file servers, NTLMv1 still enabled, weak password policy (8 chars min) allowing easy spraying, exposed RDP on 3 servers, vendor service accounts with permanent passwords, missing logging on critical OT/IoMT switches, guest WiFi reachable from clinical networks.

Before vs. After

Before Engagement

  • Domain Admin in <4 hours from any laptop
  • Medical device network unsegmented
  • EHR backend SQL injection exploitable
  • NTLMv1 enabled on all DCs
  • No formal network pentest in 24 months
  • HIPAA Security Rule technical safeguards gaps

After Remediation

  • Tiered admin model with PAW workstations
  • Medical device VLAN segmented with strict ACLs
  • EHR backend hardened, WAF deployed
  • NTLM disabled, Kerberos-only auth
  • Quarterly network pentest schedule established
  • HIPAA Security Rule controls demonstrably operational

"The path from a phished employee laptop to Domain Admin in 4 hours was eye-opening for our board. Codesecure showed us exactly what a ransomware actor would do. The remediation roadmap was specific enough that we executed it in 90 days."

Anonymous, CIO, multi-hospital group, South India

Key Lessons

What Other Teams Can Take Away

  • Flat networks are ransomware accelerators. Without segmentation, a phished workstation reaches the entire hospital network including medical devices and EHR.
  • Active Directory is the central nervous system. Kerberoasting and AS-REP roasting work in most Indian healthcare AD environments. Tier-0 separation is mandatory.
  • Medical devices need dedicated security. Generic network segmentation isn't enough; IEC 62443 and OT-aware monitoring required for IoMT.
  • EHR backend deserves dedicated VAPT. Legacy reporting modules and integration endpoints harbor SQL injection that scanners miss.

Conclusion

Healthcare networks have become high-priority ransomware targets in 2026. The combination of flat networks, weak Active Directory configurations and unsegmented medical devices creates attack paths that real-world ransomware actors exploit within hours. Comprehensive network VAPT surfaced and prioritized exactly the right remediation work.

For Indian hospitals, diagnostic chains and healthcare IT providers, network VAPT is now a board-level expectation. Codesecure delivers HIPAA + DPDP aligned network testing with executive-ready reporting and clear ransomware-readiness roadmaps, typically completing in 1-2 weeks.

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Codesecure is an ISO/IEC 27001:2022 certified cybersecurity firm. We deliver fixed-price engagements with named consultants and executive-ready outcomes across India, UAE, Saudi Arabia, Australia, Singapore and Maldives.

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