Individual provider Active NPI

Samantha Wisnefsky, PA-C

  • Physician Assistant
  • Stamford, CT
National Provider Identifier
1093533853
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Blachley Rd
Stamford, CT 06902-0002
Phone
(203) 276-2277
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CT Primary

Addresses

Primary practice location

1 Blachley Rd
Stamford, CT 06902-0002

Mailing address

1 Blachley Rd Ste 2
Stamford, CT 06902-0003
Phone (203) 276-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241115003132 CT Practitioner - Physician Assistant 9436683224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000

29 Hospital PLZ
Stamford, CT 06902-3602

32 Strawberry Hill CT
Stamford, CT 06902-2594

4 Hospital PLZ
Suite 102
Stamford, CT 06902-3602
Phone (203) 276-2330

5 High Ridge Park
Suite 103
Stamford, CT 06905-1326
Phone (203) 276-4644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6810CTMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: swisnefsky30745@stamfordhealth.direct-ci.com

Organizations & group practices 1

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1093533853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD STE 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020003",
            "telephone_number": "203-276-2277",
            "fax_number": "203-276-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020002",
            "telephone_number": "203-276-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNEFSKY",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.