NPIMap

Organization Active NPI

Family Residences & Essential Enterprises, Inc.

Doing business as Family Wellness Center

  • Multi-Specialty Clinic/Center
  • Hauppauge, NY
National Provider Identifier
1093863565
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
5157205R Issued in NY
Legal business name
FAMILY RESIDENCES & ESSENTIAL ENTERPRISES, INC.
Doing business as
Family Wellness Center
Practice address
120 Plant Ave
Hauppauge, NY 11788-3805
Phone
(631) 273-1300
Fax
(631) 273-4342
NPI assigned
Jan 8, 2007
Last updated
Nov 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Authorized official

Name
Mr. Robert S. Budd
Title
Ceo
Phone
(631) 273-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 5157205R NY Primary

Addresses

Primary practice location

120 Plant Ave
Hauppauge, NY 11788-3805

Mailing address

120 Plant Ave
Hauppauge, NY 11788-3805
Phone (631) 273-1300

Other identifiers 1

IdentifierTypeStateIssuer
02167980MedicaidNY

Other names 1

  • Family Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040327000334 NY Part B Supplier - Clinic/Group Practice 5890687453 Receives reassigned benefits from 27 practitioners
2 other NPIs on this enrollment
Practice locations: Oakdale, NY; Old Bethpage, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1093863565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PLANT AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883805",
            "telephone_number": "631-273-1300",
            "fax_number": "631-273-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PLANT AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883805",
            "telephone_number": "631-273-1300",
            "fax_number": "631-273-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY RESIDENCES & ESSENTIAL ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "BUDD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-273-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NY",
            "license": "5157205R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167980",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.