Organization Active NPI

Well Wellness Medical PLLC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1114620531
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WELL WELLNESS MEDICAL PLLC
Practice address
837 59TH St
Brooklyn, NY 11220-5576
Phone
(718) 680-8881
Fax
(718) 680-7880
NPI assigned
Mar 24, 2023
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Yong Kang He
Title
MD
Phone
(718) 680-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

837 59TH St
Brooklyn, NY 11220-5576

Mailing address

837 59TH St
Brooklyn, NY 11220-5576
Phone (718) 680-8881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230420000582 NY Part B Supplier - Clinic/Group Practice 2567827876 Receives reassigned benefits from 7 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7112 Bay Pkwy
Brooklyn, NY 11204
Phone (718) 232-8500

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1114620531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205576",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205576",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL WELLNESS MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "HE",
        "authorized_official_first_name": "YONG KANG",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-680-8881"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.