Integrated Wound Care New York Medical PLLC
Organization Active NPI General Practice Physician · Tappan, NY
NPI 1639649643 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1639649643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- INTEGRATED WOUND CARE NEW YORK MEDICAL PLLC
- Practice address
- 22 Liberty Rd
Tappan, NY 10983-1815 - Phone
- (732) 451-4318
- NPI assigned
- Dec 3, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Diane Lusas, MD
- Title
- Member
- Phone
- (732) 451-4318
Practitioners 32
-
Kimberly Rice Bickel, AGPCNP-BC
-
Frantz Dorestant Jr., CWOCN AGPCNP-BC
-
Catherine Joanna Sinnott, M.D.
-
Diane N Lusas, M.D.
-
Raheel Shafi, MD
-
Yocheved Kramer, PA
-
Julia Pojawis, PA-C
-
Ayodele O Atolagbe, M.D
-
Stephanie Ann Blakey, FNP-BC
-
Ellis Enabosi, M.D.
-
Lisa Marie Holmes, FNP
-
Shareen Ismail, M.D.
-
Jennifer Asarias Knox, M.D.
-
Jeanjacques Mbabuike, M.D.
-
Patrick T. Murphy, D.O.
-
Danielle Nikezic, FNP
-
Jeromy Ryan Patterson, M.D.
-
Michael Jay Rothstein, MSN,FNP
-
Yu Sun, MD
-
Behrad Ziapour, MD
-
Scott Herman, MD
-
Lisa Makrides, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191107000208 | NY | Part B Supplier - Clinic/Group Practice | 4486086790 |
Receives reassigned benefits from 31 practitioners Practice locations: Brooklyn, NY; Clinton, NY; Flushing, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
22 Liberty Rd
Tappan, NY 10983-1815
Mailing address
492C Cedar LN Ste 514
Teaneck, NJ 07666-1713
Other providers in Tappan, NY
- Kyong Su Han
- Ciara Anne Hargaden
- Heart Meets Mind Psychology, PLLC
- Sunjoo Hong
- Vincent M Ibelli
- Beth Jaret
- Jessie Kivlehan
- Jodi Fossner LLC
- Alina Johny
- Kochurani Shaji Joseph
All providers in Tappan, NY · General Practice Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.