Wound Care Specialists of Ny, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WOUND CARE SPECIALISTS OF NY, LLC

Practice address

100 Park Ave RM 1600
New York, NY 10017-5538

Phone

(203) 598-6046

NPI assigned

Mar 23, 2022

Organization subpart

No

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

Authorized official

Name

Jonathan Brenes

Title

Member

Phone

(203) 598-6045

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• WOUND CARE SPECIALISTS, LLC Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1922757178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BATTERSON PARK RD STE 106",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK AVE RM 1600",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175538",
            "telephone_number": "203-598-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND CARE SPECIALISTS OF NY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "BRENES",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-598-6045"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@wcspecialists.com",
            "affiliation": "N",
            "address_1": "100 Park Ave Rm 1600",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100175538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WOUND CARE SPECIALISTS, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in New York, NY
• Providers in New York, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.