Constantine Fernandez Gulmatico III, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

014230 Issued in NY

Practice address

506 6TH St
Brooklyn, NY 11215-3609

Phone

(718) 780-5942

Fax

(718) 780-3287

NPI assigned

Sep 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1962711689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 56TH DR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346820",
            "telephone_number": "917-755-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-5942",
            "fax_number": "718-780-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULMATICO",
        "first_name": "CONSTANTINE",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Gulkowitz, OTR/L
• Dolores Olaco Gulle
• Melieluck Gulle, OTR/L
• Gulmar Dental PC
• Gulmatico Medical Associates, PC
• Constantino Valderrama Gulmatico Jr., M.D.
• Frederick Anthony Gulmi, MD
• Chinmoy Gulrajani, MD
• Ramesh Gulrajani, MD
• Shaneka Gulston, LCSW

• Surgical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.