Beata Anna Wicherski, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A53981 Issued in CA

Practice address

777 Flower St Ste a
Glendale, CA 91201-3000

Phone

(818) 637-2000

Fax

(818) 242-8761

NPI assigned

May 5, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (6 of 7)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: beata.wicherski.p1@direct.lakeside.nextgenshare.com

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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642

  CA, Pediatrics

  Medicare reassignment NPD
• Emanate Health Medical Center

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  NPD (past)
• Emanate Health Medical Center

  • General Acute Care Hospital
  • Covina, CA
  • NPI 1982629440
  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  • Family Medicine Physician
  • North Hollywood, CA
  • NPI 1619975158

  Pediatrics

  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  • Rheumatology Physician
  • Burbank, CA
  • NPI 1861499535
  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1932129434

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1083662340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W WEST COVINA PKWY",
            "address_2": "STE 201",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902703",
            "telephone_number": "626-263-7020",
            "fax_number": "626-960-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHERSKI",
        "first_name": "BEATA",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A53981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A539810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• White Rose Hospice Care Inc
• Karrie White, RDHAP
• Matthew Marshall White, PMHNP-BC
• Jessica Whittington
• Whole Family Health, PC
• Wyatt Robert Wichman
• Emily V H Wieber, LMFT
• Ciara Marie Wiggins
• David Wilhoite
• William F. Reynolds, M.D., Inc.

• All providers in Glendale, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.