Individual provider Active NPI

Emmanuel Kuraun Wasem, MD

  • Internal Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1487536215
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P136614 Issued in NY
Practice address
6970 Grand Central Pkwy
Forest Hills, NY 11375-3949
Phone
(718) 263-4600
NPI assigned
Jul 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X P136614 NY
Internal Medicine Physician 207R00000X P136614 NY Primary

Addresses

Primary practice location

6970 Grand Central Pkwy
Forest Hills, NY 11375-3949

Mailing address

3104 Tulip Tree PL
Dumfries, VA 22026-4554
Phone (281) 248-6277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022000418 NY Practitioner - Internal Medicine 7517455595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

295 Kimball St
Woodbridge, NJ 07095-2518

6918 32ND Ave
Woodside, NY 11377-2033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P136614NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Solutions P.C. Internal Medicine CurrentSince Aug 15, 2025 Accepting new patients

Locations

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

6970 Grand Central Pkwy
Forest Hills, NY 11375
Phone (347) 740-1255

275 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946

154 Prospect Ave
Plattsburgh, NY 12901
Phone (518) 563-5440

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1487536215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 TULIP TREE PL",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220264554",
            "telephone_number": "281-248-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 GRAND CENTRAL PKWY",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753949",
            "telephone_number": "718-263-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASEM",
        "first_name": "EMMANUEL",
        "middle_name": "KURAUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "P136614",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P136614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.