Community Medical Wellness PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

276810-1 Issued in NY

Legal business name

COMMUNITY MEDICAL WELLNESS PC

Practice address

1041 Route 112
Port Jefferson Station, NY 11776-6000

Phone

(516) 314-5377

NPI assigned

May 2, 2018

Last updated

May 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Defilippis

Title

Operations Manager

Phone

(516) 314-5377

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 55

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.

• Lee Grayson Castro, NP

  • Acute Care Nurse Practitioner
  • New Hyde Park, NY
  • NPI 1659863462
  Medicare reassignment Care Compare group NPD
• Jessica Lyn Graff, PA

  • Physician Assistant
  • Lindenhurst, NY
  • NPI 1528186251
  Medicare reassignment Care Compare group NPD
• Lani Graham, NP

  • Adult Health Nurse Practitioner
  • Islandia, NY
  • NPI 1942727797
  Medicare reassignment Care Compare group NPD
• Tara Taheri, PA-C

  • Medical Physician Assistant
  • Garden City, NY
  • NPI 1821856212
  Medicare reassignment Care Compare group NPD
• Alexa Wood

  • Physician Assistant
  • Bay Shore, NY
  • NPI 1740745348
  Medicare reassignment Care Compare group NPD
• Joseph M Audiino, P.A.

  • Physician Assistant
  • Port Jefferson, NY
  • NPI 1487620100
  Medicare reassignment Care Compare group
• Gregory Beltrani, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Pelham, NY
  • NPI 1689094658
  Medicare reassignment Care Compare group
• Dominic A Bracco, RPAC

  • Physician Assistant
  • Mineola, NY
  • NPI 1124310164
  Medicare reassignment Care Compare group
• Josefino Bugay, RPA

  • Medical Physician Assistant
  • Rockville Centre, NY
  • NPI 1164505905
  Medicare reassignment Care Compare group
• Maria Bugay, PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Bronx, NY
  • NPI 1982461422
  Medicare reassignment Care Compare group
• Aman Deep, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1538439310
  Medicare reassignment Care Compare group
• Kieran Donnelly, PA-C

  • Physician Assistant
  • Far Rockaway, NY
  • NPI 1922646066
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1073002473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117380463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117766000",
            "telephone_number": "516-314-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "DEFILIPPIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "516-314-5377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "276810-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Collins
• Donna Collora, PA
• Kate Nicole Colucci
• Cassidy Comerford
• Community Growth Center Inc.
• Lindsay M Como, RPAC
• Complete Chiropractic Reabilitation of Port Jefferson Station LLC
• Concerned Dental Care of Port Jefferson, PLLC
• Michelle Conelli, L.M.F.T., L.C.S.W.
• Anabela Conforti

• Pain Medicine Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.