Southern Wellcare Medical PC
NPI 1396090932 · Family Medicine Physician · Bronx, NY
Southern Wellcare Medical PC is a Family Medicine Physician organization in Bronx, NY (NPI 1396090932).
Provider details
- NPI number
- 1396090932
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Svetlana Khandros, President(718) 220-0439
- License
- 228243 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2012-07-19
- Last updated
- 2019-10-17
Frequently asked questions
- What is Southern Wellcare Medical PC's NPI number?
- Southern Wellcare Medical PC's National Provider Identifier (NPI) is 1396090932, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Wellcare Medical PC?
- Southern Wellcare Medical PC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southern Wellcare Medical PC located?
- Southern Wellcare Medical PC's practice location on file with NPPES is 2336 Grand Concourse, Bronx, NY 10458-6903.
- What is Southern Wellcare Medical PC's phone number?
- The practice phone number listed in the NPPES registry for Southern Wellcare Medical PC is (718) 907-0195.
- Who is the authorized official for Southern Wellcare Medical PC?
- The authorized official listed on Southern Wellcare Medical PC's NPPES record is Svetlana Khandros, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Wellcare Medical PC's NPI active?
- Yes — Southern Wellcare Medical PC's NPI (1396090932) is active in the NPPES registry as of the last update on 2019-10-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.