Colorectal Care PLLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

COLORECTAL CARE PLLC

Practice address

2647 Coney Island Ave
Brooklyn, NY 11223-5502

Phone

(718) 743-4450

NPI assigned

May 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mychailo Fulmes, MDNPI 1992965974

Title

Sole MBR

Phone

(718) 743-4450

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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.

• Mychailo Fulmes, M.D., PH.D.

  • Colon & Rectal Surgery Physician
  • Brooklyn, NY
  • NPI 1992965974
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1073923561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045531",
            "telephone_number": "718-743-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235502",
            "telephone_number": "718-743-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORECTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "FULMES",
        "authorized_official_first_name": "MYCHAILO",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "718-743-4450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle Colon, L.C.S.W.
• Sergio Colon
• Vanessa Ivellis Colon
• Yennis Colon
• Colonial Pharmacy Inc
• James Lee Colter, LCSW
• Ruchama Deena Colton
• Edward Colucci, RPA-C
• Nicole Marie Colucci, PA-C
• Rocco Coluccio, PT, MA

• Colon & Rectal Surgery Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Colon & Rectal Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.