Daniel R Wiest, RPAC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0039611 Issued in NY

Practice address

11835 RT 9W
West Coxsackie, NY 12192-3605

Phone

(518) 731-9000

Fax

(518) 731-9119

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Provident Emergency Medicine Associates, PC

  • Emergency Medicine Physician
  • Schenectady, NY
  • NPI 1750310645
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1073593927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 RT 9W",
            "city": "WEST COXSACKIE",
            "state": "NY",
            "postal_code": "121923605",
            "telephone_number": "518-731-9000",
            "fax_number": "518-731-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 RT 9W",
            "city": "WEST COXSACKIE",
            "state": "NY",
            "postal_code": "121923605",
            "telephone_number": "518-731-9000",
            "fax_number": "518-731-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEST",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "0039611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE NY",
            "identifier": "275191",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "4937930001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "DW05762L10",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10050348",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NENY",
            "identifier": "000406870004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Kimberly Smith I, DPT
• Alison H Spear, MD
• Jennifer Michele Stall, PA-C
• Jailene Stapleton, PA-C
• Kasparas Vilimas
• Konnor V Williams, PA-C
• Ann F Withjack, RPH
• Shannon Elizabeth Yearwood
• Jolene Marie Yost, LMT

• Emergency Medicine Physician in West Coxsackie, NY
• Providers in West Coxsackie, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.