Stanley Walter Wisnioski III, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

OS9152 Issued in FL

Practice address

10887 N Military TRL Ste 5
Palm Beach Gardens, FL 33410-6528

Phone

(561) 324-9600

Fax

(561) 799-9980

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Osteopathic Manipulative MedicineAlso: General Practice

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Palm Beach Osteopathic Care, Inc.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Palm Beach Gardens, FL
  • NPI 1497964407
  Medicare reassignment NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1043399900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10887 N MILITARY TRL STE 5",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106528",
            "telephone_number": "561-324-9600",
            "fax_number": "561-779-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10887 N MILITARY TRL STE 5",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106528",
            "telephone_number": "561-324-9600",
            "fax_number": "561-799-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIOSKI",
        "first_name": "STANLEY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9152",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS9152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "52028",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "K6281",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SIFFIX",
            "identifier": "U3317Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "OS9152",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Nicole Wilson, PA-C
• Sophia Elizabeth Holden Wiltse, BA
• Katherine Elizabeth Wimmer
• Tara Marie Wingard, PA
• Kenneth P Winnard, MD
• Hillary Ellen Wohl, PH.D.
• Kevin Richard Wolak, PT, DPT
• Rolf Wolfrom, D.D.S
• Michael Richard Wolov, DDS
• Emily Ann Woltering

• Neuromusculoskeletal Medicine & OMM Physician in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.