Organization Active NPI

Wellcome Care Medical

  • Pediatrics Physician
  • Far Rockaway, NY
National Provider Identifier
1689424160
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WELLCOME CARE MEDICAL
Practice address
2915 Far Rockaway Blvd
Far Rockaway, NY 11691-1941
Phone
(718) 310-6049
Fax
(718) 310-6070
NPI assigned
Mar 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Authorized official

Name
Randi B Nelson, MDNPI 1215247895
Title
Ceo/Medical Director
Phone
(718) 310-6049

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2915 Far Rockaway Blvd
Far Rockaway, NY 11691-1941

Mailing address

2915 Far Rockaway Blvd
Far Rockaway, NY 11691-1941
Phone (718) 310-6049

Other identifiers 1

IdentifierTypeStateIssuer
07932130MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240516001591 NY Part B Supplier - Clinic/Group Practice 2365883758 Receives reassigned benefits from 6 practitioners
Practice locations: Far Rockaway, NY

National Provider Directory

National Provider Directory

Locations

2915 Far Rockaway Blvd
Far Rockaway, NY 11691
Phone (347) 230-4076

Practitioners & affiliated clinicians

Practitioners 6

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": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779408000000",
    "number": "1689424160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 FAR ROCKAWAY BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911941",
            "telephone_number": "718-310-6049",
            "fax_number": "718-310-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 FAR ROCKAWAY BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911941",
            "telephone_number": "718-310-6049",
            "fax_number": "718-310-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCOME CARE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-310-6049",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07932130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; 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.