Organization Active NPI

Ny Be Well Medical PC

  • Pain Medicine Physician
  • New York, NY
National Provider Identifier
1215402870
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
NY BE WELL MEDICAL PC
Practice address
20 E 46TH St FL 9
New York, NY 10017-9249
Phone
(212) 404-8090
Fax
(212) 404-8091
NPI assigned
Oct 10, 2018
Last updated
Dec 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Varuzhan Dovlatyan, MD
Title
Authorized Official
Phone
(212) 404-8090

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Family Medicine Physician 207Q00000X NU
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

20 E 46TH St FL 9
New York, NY 10017-9249

Mailing address

20 E 46TH St FL 9
New York, NY 10017-9249
Phone (212) 404-8090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181212003215 NY Part B Supplier - Clinic/Group Practice 8325383730 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1215402870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100179249",
            "telephone_number": "212-404-8090",
            "fax_number": "212-404-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100179249",
            "telephone_number": "212-404-8090",
            "fax_number": "212-404-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY BE WELL MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "DOVLATYAN",
        "authorized_official_first_name": "VARUZHAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "212-404-8090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.