Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Evernorth Medical Care Providers New York Professional Corporation

Organization Family Medicine Physician · NPI 1205234291

Evernorth Medical Care Providers New York Professional Corporation is a Family Medicine Physician in Melville, New York. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
7
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Practice location Address checks out

555 Broadhollow Rd Ste 305
Melville, NY 11747-5018
Phone: (773) 292-4800
Fax: (312) 564-4059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Adult Medicine Physician Taxonomy 207QA0505X
Hospice and Palliative Medicine (Family Medicine) Physician Taxonomy 207QH0002X
Internal Medicine Physician Taxonomy 207R00000X
Hospice and Palliative Medicine (Internal Medicine) Physician Taxonomy 207RH0002X
Podiatrist Taxonomy 213E00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1205234291
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacqueline Lakes — Senior Paralegal · (954) 446-0640
Other names Dirk Wales Md Pc; Dirk Wales Md Pc
NPI enumeratedDecember 8, 2014
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025
Mailing address730 Cool Springs Blvd Ste 500, Franklin, TN 37067-7331

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