Integrated Medical Health Wellness P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRATED MEDICAL HEALTH WELLNESS P C

Practice address

125 E Central Ave
Pearl River, NY 10965-2543

Phone

(914) 269-8777

NPI assigned

Feb 12, 2024

Organization subpart

No

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

Authorized official

Name

Shawn K Samuel, D.O.NPI 1649366204

Title

President

Phone

(914) 269-8777

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Kunjumon Samuel, DO, MS

  • Hospitalist Physician
  • Bronx, NY
  • NPI 1649366204

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1467216366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 PALMER AVE # 1050",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382437",
            "telephone_number": "914-269-8777",
            "fax_number": "888-300-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652543",
            "telephone_number": "914-269-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL HEALTH WELLNESS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-10",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-269-8777",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Hughes
• Meaghan Isabelle Hurley
• Yildiz Huuskes, PT
• Michael Ingargiola, MD
• Ingrid L. Montgomery MD MPH PLLC
• Robert Daniel Jablonski Jr., MD
• Lisa Marie Janelli-Morano, DNP, RN, FNP-BC
• Lora Enriquez Jarabelo, NP
• Jay D. Helman DPM PC
• Rennie Jhingoor

• Internal Medicine Physician in Pearl River, NY
• Providers in Pearl River, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.