Kinwell Medical Services, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KINWELL MEDICAL SERVICES, PC

Practice address

41 Brunswick St FL 1
Staten Island, NY 10314

Phone

(718) 983-0660

NPI assigned

Mar 5, 2007

Last updated

Nov 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cherry Mar-Chan, MDNPI 1629041504

Title

VP

Phone

(718) 983-0660

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBJEAA

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.

• Cherry Mar-Chan, MD

  • Family Medicine Physician
  • Staten Island, NY
  • NPI 1629041504
  Medicare reassignment Care Compare group NPD Authorized official
• Yeoman Kin-Lung Chan, MD

  • Family Medicine Physician
  • Staten Island, NY
  • NPI 1811960446
  Medicare reassignment Care Compare group NPD
• Nicholas Panagiotis Roussis, MD

  • Obstetrics & Gynecology Physician
  • Staten Island, NY
  • NPI 1497749089
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1447389630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BRUNSWICK ST FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146017",
            "telephone_number": "718-983-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BRUNSWICK ST FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-983-0660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1655 Richmond Ave",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103141570",
            "country_code": "US",
            "telephone_number": "718-983-0660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 Richmond Ave",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103141570",
            "country_code": "US",
            "telephone_number": "718-983-0660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINWELL MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "MAR-CHAN",
        "authorized_official_first_name": "CHERRY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "718-983-0660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02797482",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "102582",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7629766",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shantrice Niomi King, CNM, WHNP
• Kings Psychological Services
• David H. Kingsley, PHD
• Nikki Carmen Kinnear
• Danielle Kinsman
• Nancy P Kinzler, APRN,BC
• Jane Kiperman, PHARM.D., R.PH
• Brittany Kipnis
• Janine Kipp, M.A. CCC-SLP
• Ronald George Kipp, MD

• Family Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.