Wellcare Medical of Long Island PLLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

WELLCARE MEDICAL OF LONG ISLAND PLLC

Practice address

85 S Ocean Ave
Patchogue, NY 11772-3702

Phone

(516) 412-7873

NPI assigned

Apr 17, 2021

Organization subpart

No

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

Authorized official

Name

Evan B. Shapiro, MD

Title

Owner

Phone

(516) 680-3900

Specialties & licenses 1

Addresses

Other names 1

• Pure Medical Doing business as

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1114508587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 UNION TPKE STE 206",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401759",
            "telephone_number": "516-680-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 S OCEAN AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723702",
            "telephone_number": "516-412-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE MEDICAL OF LONG ISLAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-17",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-680-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pure Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colleen M Washington, LMHC
• John M Waterman, CASAC
• Lindsay Wedell
• Richard Michael Weintraub, DDS
• Kelly Welch
• Wellcare Medical of New York PLLC
• Wellcare Medical of North Shore
• David Weltman, M.D.
• Elizabeth Anne Westendorf, PA-C
• Elizabeth Ann Westhoff-Smejc, L.C.S.W.

• Pain Medicine Physician in Patchogue, NY
• Providers in Patchogue, 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 Dec 9, 2022; 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.