Healthcare Provider Details

I. General information

NPI: 1831037761
Provider Name (Legal Business Name): ENCOMPASS MEDICAL WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 ROCKAWAY AVE
BROOKLYN NY
11212-5635
US

IV. Provider business mailing address

381 ROCKAWAY AVE
BROOKLYN NY
11212-5635
US

V. Phone/Fax

Practice location:
  • Phone: 718-522-3400
  • Fax:
Mailing address:
  • Phone: 718-522-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SEYED MORTEZA MAHMOUDI
Title or Position: PRESIDENT
Credential: MD
Phone: 718-522-3400