Community Wellness Physician PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMMUNITY WELLNESS PHYSICIAN PLLC

Practice address

1471 Dekalb Ave
Brooklyn, NY 11237-3894

Phone

(347) 350-9344

Fax

(347) 240-4434

NPI assigned

Jun 10, 2013

Organization subpart

No

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

Authorized official

Name

Gopi K Punukollu, MDNPI 1184839284

Title

Medical Director

Phone

(347) 350-9344

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Interoperability endpoints

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

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.

• Gopi K Punukollu, M.D

  • Cardiovascular Disease Physician
  • Brooklyn, NY
  • NPI 1184839284
  Medicare reassignment Care Compare group NPD Authorized official
• Hima Bindu Punukollu, MD

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1104989490
  Medicare reassignment Care Compare group NPD
• Keiko Leger, P.A.

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1730516170
  Medicare reassignment

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1619315801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373894",
            "telephone_number": "347-350-9344",
            "fax_number": "347-240-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373894",
            "telephone_number": "347-350-9344",
            "fax_number": "347-240-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY WELLNESS PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "PUNUKOLLU",
        "authorized_official_first_name": "GOPI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "347-350-9344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Physical Therapy of Brooklyn, PLLC
• Community Radiology
• Community Rehabilitation Services
• Community RX Inc (Foster Maaz Pharmacy)
• Community Urgent Care PC
• Angelina Como
• Cristina Como, OTR/L
• Nancy Lynn Comodo, P.T.
• Rosemay Compail
• Gina Compas

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, 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 Jun 10, 2013; 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.