Active NPI
Corr Health Ec, PC
- Primary Care Clinic/Center
- Woodmere, NY
National Provider Identifier
1639035447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- CORR HEALTH EC, PC
- Practice address
- 961 Broadway Ste 103
Woodmere, NY 11598-1733 - Phone
- (212) 516-8548
- NPI assigned
- Dec 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Paull
- Title
- Administrator
- Phone
- (313) 516-8548
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
961 Broadway Ste 103
Woodmere, NY 11598-1733
Mailing address
961 Broadway Ste 103
Woodmere, NY 11598-1733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260618003485 | NY | Part B Supplier - Clinic/Group Practice | 4789160060 |
Receives reassigned benefits from 1 practitioner Practice locations: Woodmere, NY |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Corr Health Ec PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Toms River, NJ
- NPI 1386514156
Locations
961 Broadway
Woodmere, NY 11598
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Howard Beach, NY
- NPI 1871112623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1766620800000",
"number": "1639035447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "961 BROADWAY STE 103",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "961 BROADWAY STE 103",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981733",
"telephone_number": "212-516-8548"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORR HEALTH EC, PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-12-25",
"last_updated": "2025-12-25",
"certification_date": "2025-12-25",
"status": "A",
"authorized_official_last_name": "PAULL",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "313-516-8548"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodmere, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.