Organization Active NPI

Allwell Health Medical PC

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1427822196
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALLWELL HEALTH MEDICAL PC
Practice address
4161 Kissena Blvd Ste C
Flushing, NY 11355-3105
Phone
(718) 878-6920
Fax
(718) 878-6920
NPI assigned
Nov 13, 2023
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Dr. Shuhua Song, MDNPI 1902216328
Title
MD
Phone
(718) 878-6920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Hospitalist Physician 208M00000X

Addresses

Primary practice location

4161 Kissena Blvd Ste C
Flushing, NY 11355-3105

Mailing address

PO Box 604675
Bayside, NY 11360-4675
Phone (718) 878-6920

Other names 2

  • Allwell Medical Health PC Other name
  • Allwell Medical PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240215000878 NY Part B Supplier - Clinic/Group Practice 7012351380 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1427822196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604675",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113604675",
            "telephone_number": "718-878-6920",
            "fax_number": "718-878-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD STE C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553105",
            "telephone_number": "718-878-6920",
            "fax_number": "718-878-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLWELL HEALTH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "SHUHUA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-878-6920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allwell Medical Health PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Allwell Medical PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.