COMMUNITY WELLNESS PHYSICIAN PLLC
NPI 1619315801
Internal Medicine in Brooklyn, NY
About Community Wellness Physician Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COMMUNITY WELLNESS PHYSICIAN PLLC (NPI 1619315801) is a healthcare organization registered as an internal medicine in Brooklyn, New York and active in the NPI registry since June 2013. The organization lists Gopi K Punukollu, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Community Wellness Physician Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Community Wellness Physician PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Brooklyn, NY 11236
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Community Wellness Physician PLLC's NPI number?
The NPI number for Community Wellness Physician PLLC is 1619315801. It was assigned to this organization in the NPPES registry on June 10, 2013.
Where is Community Wellness Physician PLLC located?
Community Wellness Physician PLLC is located at 1471 Dekalb Ave, Brooklyn, NY 11237. The listed phone number is (347) 350-9344.
What is Community Wellness Physician PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Community Wellness Physician PLLC enrolled in Medicare?
Yes. Community Wellness Physician PLLC is registered in the Medicare PECOS enrollment system.
When is Community Wellness Physician PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Community Wellness Physician PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Community Wellness Physician PLLC, in Cardiovascular Disease (Cardiology) and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Community Wellness Physician PLLC was last updated on June 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Community Wellness Physician Pllc · NPI 1619315801
Internal Medicine organization in Brooklyn, New York. Organization record, active in the CMS NPPES registry since June 10, 2013.
## Identity
- **NPI:** 1619315801 (Entity type: Organization)
- **Enumerated:** June 10, 2013
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Gopi Punukollu, MEDICAL DIRECTOR
## Practice location
- **Address:** 1471 DEKALB AVE, Brooklyn, NY 11237-3894
- **Phone:** (347) 350-9344 · **Fax:** (347) 240-4434
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Cardiovascular Disease (Cardiology) (1), Internal Medicine (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 10, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1619315801) · Data from the CMS NPPES public registry.