Medical and Wellness Practice PLLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

MEDICAL AND WELLNESS PRACTICE PLLC

Practice address

554 Tompkins Ave
Staten Island, NY 10305-1745

Phone

(877) 241-2772

NPI assigned

Nov 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. John Sou-Cheng Shiau, MDNPI 1346221058

Title

President

Phone

(917) 886-5276

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John S Shiau, MD

  • Neurological Surgery Physician
  • Staten Island, NY
  • NPI 1346221058
  NPD (past) Authorized official

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1104427442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 103",
            "city": "HILLSDALE",
            "state": "NJ",
            "postal_code": "076420103",
            "telephone_number": "201-522-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 TOMPKINS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051745",
            "telephone_number": "877-241-2772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Business Park Dr",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135026302",
            "country_code": "US",
            "telephone_number": "877-241-2772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "139 Fulton St Rm 136",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100382538",
            "country_code": "US",
            "telephone_number": "877-241-2772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL AND WELLNESS PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "SHIAU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SOU-CHENG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-886-5276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Orthopaedic Surgery of the Spine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.