Individual provider Active NPI

Mary M Wilsch, M.D.

  • Obstetrics & Gynecology Physician
  • Penfield, NY
National Provider Identifier
1013973734
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
214652 Issued in NY
Practice address
21 Willow Pond Way Ste 100
Penfield, NY 14526
Phone
(585) 641-0399
Fax
(585) 641-0388
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 214652 NY Primary

Addresses

Primary practice location

21 Willow Pond Way Ste 100
Penfield, NY 14526

Mailing address

21 Willow Pond Way Ste 100
Penfield, NY 14526-2687
Phone (585) 697-3201

Other practice location 1

408 N Main St
Warsaw, NY 14569-1015
Phone (585) 786-1560

Other practice location 2

600 E Genesee St
Suite 323
Syracuse, NY 13202-3130
Phone (315) 476-1645

Other practice location 3

990 South Ave Ste 200
Rochester, NY 14620-2740
Phone (585) 232-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000553 NY Practitioner - Obstetrics/Gynecology 9830288935 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Buffalo School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highlands Womens HealthGroup PAC ID 8426283623, 35 clinicians

Practice addresses (Care Compare)

800 Ayrault Rd
Suite 100
Fairport, NY 14450-8941
Phone (585) 602-0440

Hospital & facility affiliations

  • Highland Hospital Hospital, Rochester, NY, CCN 330164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
214652NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Womens Health Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Genesee Valley Obstetrics & Gynecology, P.C. CurrentSince Jul 15, 2013 Accepting new patients
St James Hospital CurrentSince Jan 1, 2018 Accepting new patients
Highland Hospital of Rochester Past Accepting new patients

Locations

800 Ayrault Rd
Ste 100
Fairport, NY 14450
Phone (585) 602-0440

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

21 Willow Pond Way
Ste 100
Penfield, NY 14526
Phone (585) 641-0399

1000 South Ave
#116
Rochester, NY 14620
Phone (585) 341-6734

990 South Ave
Ste 103
Rochester, NY 14620
Phone (585) 232-3210

990 South Ave
Ste 200
Rochester, NY 14620
Phone 5852323210 ext. 315

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1013973734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY STE 100",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-697-3201",
            "fax_number": "585-641-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY STE 100",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "14526",
            "telephone_number": "585-641-0399",
            "fax_number": "585-641-0388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 N Main St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NY",
            "postal_code": "145691015",
            "country_code": "US",
            "telephone_number": "585-786-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Genesee St",
            "address_2": "Suite 323",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132023130",
            "country_code": "US",
            "telephone_number": "315-476-1645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "990 South Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202740",
            "country_code": "US",
            "telephone_number": "585-232-3210",
            "fax_number": "585-641-0388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSCH",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "214652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.