| 1211 Wpr Medical Services Pc | |
|
1211 White Plains Rd Bronx NY 10472-4900 | |
| (718) 082-8066 | |
| (718) 829-9132 |
| Full Name | 1211 Wpr Medical Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1211 White Plains Rd, Bronx, New York |
| Authorized Official Name and Position | Amy Carol Polan (AM) |
| Authorized Official Contact | 7188286610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1211 Wpr Medical Services Pc 1211 White Plains Rd Bronx NY 10472-4900 Ph: (718) 828-6610 | 1211 Wpr Medical Services Pc 1211 White Plains Rd Bronx NY 10472-4900 Ph: (718) 082-8066 |
| NPI Number | 1437247509 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/30/2021 |
| Medicare PECOS PAC ID | 5395635502 |
|---|---|
| Medicare Enrollment ID | O20091116000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437247509 | NPI | - | NPPES |
| 02770029 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 0810561 (New York) | Secondary |
| Provider Name | Albert Graziosa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205927498 PECOS PAC ID: 0446245831 Enrollment ID: I20040415001115 |
| Provider Name | David I Weiss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619052131 PECOS PAC ID: 4183610637 Enrollment ID: I20040421001286 |
| Provider Name | Carol Sasportas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487611711 PECOS PAC ID: 1254329329 Enrollment ID: I20040505001588 |
| Provider Name | John S Auricchio |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356437388 PECOS PAC ID: 6204826894 Enrollment ID: I20040515000047 |
| Provider Name | Justyna Watkowska |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1881666097 PECOS PAC ID: 7810978061 Enrollment ID: I20040525001168 |
| Provider Name | Mark Harooni |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013014406 PECOS PAC ID: 9931012176 Enrollment ID: I20040622000503 |
| Provider Name | Raphael Novogrodsky |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134161201 PECOS PAC ID: 0244207546 Enrollment ID: I20040915000963 |
| Provider Name | Jonathan A Sheindlin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598861668 PECOS PAC ID: 9234196999 Enrollment ID: I20041214000654 |
| Provider Name | Premetesh Chattoo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255395083 PECOS PAC ID: 2466419775 Enrollment ID: I20041217000295 |
| Provider Name | Srinivas Kesanakurthy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770558397 PECOS PAC ID: 5890714356 Enrollment ID: I20051115000223 |
| Provider Name | Jodumutt G Bhat |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356390603 PECOS PAC ID: 7618969965 Enrollment ID: I20051228000724 |
| Provider Name | Stephan B Simons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710928304 PECOS PAC ID: 4385658590 Enrollment ID: I20060126000660 |
| Provider Name | Provat C Das |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598964835 PECOS PAC ID: 1850486093 Enrollment ID: I20071002000760 |
| Provider Name | Shahanaz Begum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437391810 PECOS PAC ID: 3870622269 Enrollment ID: I20100524000297 |
| Provider Name | Jay P Babich |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275862732 PECOS PAC ID: 3870626203 Enrollment ID: I20100805000053 |
| Provider Name | Nicole M Castillo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225357197 PECOS PAC ID: 9830214535 Enrollment ID: I20100918000066 |
| Provider Name | Elizabeth Mathew |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447571393 PECOS PAC ID: 4981891819 Enrollment ID: I20101204000103 |
| Provider Name | Aditya Mangla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548453285 PECOS PAC ID: 4486834512 Enrollment ID: I20110208000019 |
| Provider Name | Shailja D Mukhtyar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881945665 PECOS PAC ID: 2264677053 Enrollment ID: I20130327000321 |
| Provider Name | Renee L Wilson-bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134382492 PECOS PAC ID: 4587890421 Enrollment ID: I20131122001385 |
| Provider Name | Subhas Chandra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518308220 PECOS PAC ID: 9931337540 Enrollment ID: I20140106000108 |
| Provider Name | Samir Garyali |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1679704605 PECOS PAC ID: 3072745751 Enrollment ID: I20140714001862 |
| Provider Name | Vinaya V Gaduputi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588829188 PECOS PAC ID: 0547576282 Enrollment ID: I20150826001521 |
| Provider Name | Omar Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831517002 PECOS PAC ID: 9436466471 Enrollment ID: I20150923001953 |
| Provider Name | Tejas Bharat Patel |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1497041776 PECOS PAC ID: 2567763659 Enrollment ID: I20151215000101 |
| Provider Name | Deborah Kendrick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811310154 PECOS PAC ID: 8224334040 Enrollment ID: I20160304000179 |
| Provider Name | Jeanette Kreuze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093119596 PECOS PAC ID: 4880991298 Enrollment ID: I20160330001848 |
| Provider Name | Maria S Agao |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194920686 PECOS PAC ID: 0042509697 Enrollment ID: I20160520000740 |
| Provider Name | Armel Alexis Dogruluk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992225114 PECOS PAC ID: 7315297678 Enrollment ID: I20180906002597 |
| Provider Name | Felix Raju |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295157667 PECOS PAC ID: 1759635303 Enrollment ID: I20181116001902 |
| Provider Name | Seeam Nur Haque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487041554 PECOS PAC ID: 7113261702 Enrollment ID: I20181210000278 |
| Provider Name | Neelima Nadella |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1043499783 PECOS PAC ID: 6305088394 Enrollment ID: I20190104000775 |
| Provider Name | Daryl J Augustine |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164879037 PECOS PAC ID: 4284974593 Enrollment ID: I20190826000379 |
| Provider Name | Zerremi D Caga-anan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528312394 PECOS PAC ID: 7618391095 Enrollment ID: I20200717001201 |
| Provider Name | Harriet A Yeboah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174123574 PECOS PAC ID: 2062823297 Enrollment ID: I20201119001933 |
| Provider Name | Hyunjae Lee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568777613 PECOS PAC ID: 5294148334 Enrollment ID: I20210108000924 |
| Provider Name | Chirag Dalal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417546433 PECOS PAC ID: 9335556844 Enrollment ID: I20210330001634 |
| Provider Name | Kesha Pantry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386225001 PECOS PAC ID: 9931508975 Enrollment ID: I20210525001919 |
| Provider Name | Stephanie Duverge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053819326 PECOS PAC ID: 2668874710 Enrollment ID: I20210712002572 |
| Provider Name | Wendy Renee Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033673132 PECOS PAC ID: 3577951235 Enrollment ID: I20211028003050 |
| Provider Name | Shernette Samuels - Bremnor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346846995 PECOS PAC ID: 5395130454 Enrollment ID: I20220328001657 |
| Provider Name | Ruth Yeboah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477188167 PECOS PAC ID: 5496132763 Enrollment ID: I20220509000181 |
| Provider Name | Nicholas Nsiah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992324891 PECOS PAC ID: 7214310564 Enrollment ID: I20220818002242 |
| Provider Name | Falla Lawrence Polycarpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346898137 PECOS PAC ID: 3577946565 Enrollment ID: I20220824002545 |
| Provider Name | Chenel Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245622661 PECOS PAC ID: 4880078377 Enrollment ID: I20220901001272 |
| Provider Name | Alondra Severino |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871378182 PECOS PAC ID: 2961851530 Enrollment ID: I20231207001784 |
Mmc Medical Park At 1635 Poplar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Mmc Medical Park At 1635 Poplar, 1635 Poplar Street, Bronx, NY 10461 Phone: 914-377-4722 | |
Mmc At Aecom Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Morris Park Avenue, Mmc At Aecom, Bronx, NY 10461 Phone: 914-377-4722 | |
Brightpoint Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1543-1545 Inwood Avenue, Bronx, NY 10452 Phone: 855-687-8700 Fax: 718-294-4765 | |
Aramark Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 Grand Concourse, Bronx, NY 10457 Phone: 646-641-7427 | |
Montefiore Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 E 161st St, Bronx, NY 10451 Phone: 718-920-4321 | |
Amth Medical Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 E 149th St, 4th Floor, Bronx, NY 10455 Phone: 718-665-8300 | |
New Genesis Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 E Tremont Ave Fl 2, Bronx, NY 10465 Phone: 718-828-1549 Fax: 516-303-0968 |