Organization Active NPI

Wellness Osteopathic Family Medicine

  • Family Medicine Physician
  • Rego Park, NY
National Provider Identifier
1518795202
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS OSTEOPATHIC FAMILY MEDICINE
Practice address
6271 Woodhaven Blvd
Rego Park, NY 11374-2896
Phone
(347) 338-0503
Fax
(718) 957-4668
NPI assigned
Jul 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Dr. Elisheva Rubinova, DONPI 1063832467
Title
Owner
Phone
(347) 338-0503

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6271 Woodhaven Blvd
Rego Park, NY 11374-2896

Mailing address

6271 Woodhaven Blvd
Rego Park, NY 11374-2896
Phone (347) 338-0503

Other identifiers 1

IdentifierTypeStateIssuer
289369OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250213002569 NY Part B Supplier - Clinic/Group Practice 3476083882 Receives reassigned benefits from 1 practitioner
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Locations

16040 78th Rd
Ste 200
Fresh Meadows, NY 11366
Phone (718) 544-1444

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1518795202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6271 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742896",
            "telephone_number": "347-338-0503",
            "fax_number": "718-957-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6271 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742896",
            "telephone_number": "347-338-0503",
            "fax_number": "718-957-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OSTEOPATHIC FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "RUBINOVA",
        "authorized_official_first_name": "ELISHEVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-338-0503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "289369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.