Active NPI
Wellcare of BX Medical PC
- Family Medicine Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 228243
- Legal business name
- WELLCARE OF BX MEDICAL PC
- Practice address
- 2336 Grand Concourse
Bronx, NY 10458-6903 - Phone
- (718) 220-0439
- Fax
- (718) 933-2914
- NPI assigned
- Sep 8, 2016
- 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
- Dr. Svetlana Khandros, D.O
- Title
- Owner
- Phone
- (718) 220-0439
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 228243 | NY | Primary |
Addresses
Primary practice location
2336 Grand Concourse
Bronx, NY 10458-6903
Mailing address
2336 Grand Concourse
Bronx, NY 10458-6903
Phone (718) 220-0439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2275534 | Wellcare of BX Medical PC | Certificate of waiver | Jan 23, 2027 |
National Provider Directory
National Provider DirectoryLocations
326 E 149th St
Fl 1
Bronx, NY 10451
2336 Grand Concourse
Bronx, NY 10458
Phone (718) 220-0439
2336 Grand Concourse
#1A
Bronx, NY 10458
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1871578872
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1871524538
-
- Cardiovascular Disease Physician
- New York, NY
- NPI 1285845370
-
- Podiatrist
- Bronx, NY
- NPI 1710959945
-
- Psychiatric/Mental Health Nurse Practitioner
- Far Rockaway, NY
- NPI 1659682920
-
- Foot & Ankle Surgery Podiatrist
- Bronx, NY
- NPI 1164879037
-
- Diagnostic Radiology Physician
- Rego Park, NY
- NPI 1285634576
-
- Family Nurse Practitioner
- Bronx, NY
- NPI 1114482452
-
- Obstetrics & Gynecology Physician
- Brooklyn, NY
- NPI 1811017916
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1720050040
-
- Physical Therapist
- Forest Hills, NY
- NPI 1871117218
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1473292800000",
"number": "1851848618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104586903",
"telephone_number": "718-220-0439",
"fax_number": "718-933-2914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2336 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104586903",
"telephone_number": "718-220-0439",
"fax_number": "718-933-2914"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLCARE OF BX MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-09-08",
"last_updated": "2016-09-08",
"status": "A",
"authorized_official_last_name": "KHANDROS",
"authorized_official_first_name": "SVETLANA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "718-220-0439",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": "228243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.