NPIMap

Organization Active NPI

Complete Wellness Medical PC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1851737209
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
256120 Issued in NY
Legal business name
COMPLETE WELLNESS MEDICAL PC
Practice address
551 Madison Ave Ste 1201
New York, NY 10022-3390
Phone
(212) 737-0000
Fax
(212) 223-5700
NPI assigned
May 13, 2013
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Jerald Korman, M.D.
Title
President
Phone
(212) 737-9000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X04080-1 NY
Chiropractor 111N00000X 011670X NY
Family Medicine Physician 207Q00000X 256120 NY Primary
Physical Medicine & Rehabilitation Physician 208100000X 261708 NY

Addresses

Primary practice location

551 Madison Ave Ste 1201
New York, NY 10022-3390

Mailing address

551 Madison Ave Ste 1201
New York, NY 10022-3390
Phone (212) 737-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150126001236 NY Part B Supplier - Clinic/Group Practice 2567786486 Receives reassigned benefits from 14 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

551 Madison Ave
Ste 1201
New York, NY 10022
Phone (212) 737-0000

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1851737209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 MADISON AVE STE 1201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223390",
            "telephone_number": "212-737-0000",
            "fax_number": "212-223-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 MADISON AVE STE 1201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223390",
            "telephone_number": "212-737-0000",
            "fax_number": "212-223-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE WELLNESS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "KORMAN",
        "authorized_official_first_name": "JERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-737-9000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X04080-1",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011670X",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "256120",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "261708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.