NPIMap

Organization Active NPI

Innovation Wound Care Associates, LLC

  • Specialist
  • Valley Stream, NY
National Provider Identifier
1003244138
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
115251 Issued in NY
Legal business name
INNOVATION WOUND CARE ASSOCIATES, LLC
Practice address
20 E Sunrise Hwy
Suite 301
Valley Stream, NY 11581-1260
Phone
(516) 569-2828
Fax
(516) 295-4145
NPI assigned
Oct 29, 2013
Last updated
Oct 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Dr. Gilbert G. Makabali, MDNPI 1689645079
Title
President
Phone
(516) 569-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 115251 NY Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X 006327 NY

Addresses

Primary practice location

20 E Sunrise Hwy
Suite 301
Valley Stream, NY 11581-1260

Mailing address

20 E Sunrise Hwy
Suite 301
Valley Stream, NY 11581-1260
Phone (516) 569-2828

National Provider Directory

National Provider Directory

Locations

20 E Sunrise Hwy
Ste 301
Valley Stream, NY 11581
Phone (516) 569-2828

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1003244138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E SUNRISE HWY",
            "address_2": "SUITE 301",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811260",
            "telephone_number": "516-569-2828",
            "fax_number": "516-295-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E SUNRISE HWY",
            "address_2": "SUITE 301",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811260",
            "telephone_number": "516-569-2828",
            "fax_number": "516-295-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION WOUND CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "MAKABALI",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-569-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "115251",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.