Advanced Wound Care Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

218265 Issued in NY

Legal business name

ADVANCED WOUND CARE MEDICAL PC

Practice address

454 Avenue U
Brooklyn, NY 11223-4011

Phone

(718) 382-3400

Fax

(718) 382-3420

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sergei Kochlatyi, M.D.NPI 1104877836

Title

Medical Director

Phone

(718) 382-3400

Specialties & licenses 5

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergei Kochlatyi, M.D.

  • Internal Medicine Physician
  • Cresskill, NJ
  • NPI 1104877836
  NPD (past) Authorized official

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1699726315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234011",
            "telephone_number": "718-382-3400",
            "fax_number": "718-382-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234011",
            "telephone_number": "718-382-3400",
            "fax_number": "718-382-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOUND CARE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "KOCHLATYI",
        "authorized_official_first_name": "SERGEI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-382-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "218265",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "150869",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "087860",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "227059",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "156598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "07132",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advanced Surgical Artistry, PC
• Advanced Surgical Urology PC
• Advanced Therapeutic Solutions
• Advanced Urology Associates, P.C.
• Advanced Walk-in Foot Care, PLLC
• Advancing Avenues ABA LLC
• Advanta Medical P.C.
• Advanta Medical PC
• Advantage Choice Care, LLC
• Advantage Management Associates (advantage home care agency)

• 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 Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.