Impact Care Medical Services MN PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMPACT CARE MEDICAL SERVICES MN PC

Practice address

905 Elm St
Farmington, MN 55024-1188

Phone

(718) 964-6161

NPI assigned

Nov 5, 2026

Last updated

Nov 5, 2026By 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

Eli Wercberger

Title

Owner

Phone

(917) 627-2130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1793836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793836800000",
    "number": "1518866458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 STIRLING RD STE 207",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 ELM ST",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550241188",
            "telephone_number": "718-964-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CARE MEDICAL SERVICES MN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-11-05",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A",
        "authorized_official_last_name": "WERCBERGER",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-627-2130"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.