Individual provider Active NPI

Eric Wisotzky, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Washington, DC
National Provider Identifier
1104845098
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD039832 Issued in DC
Practice address
102 Irving St NW
Washington, DC 20010-2921
Phone
(202) 877-1621
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD039832 DC Primary

Addresses

Primary practice location

102 Irving St NW
Washington, DC 20010-2921

Mailing address

102 Irving St NW
Washington, DC 20010-2921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120313000753 DC Practitioner - Physical Medicine and Rehabilitation 1052570975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Albany Medical College of Union University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039832DCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

102 Irving St NW
Washington, DC 20010
Phone (202) 877-1587

102 Irving St NW
Ste 1332
Washington, DC 20010

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 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1104845098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921",
            "telephone_number": "202-877-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOTZKY",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DC",
            "license": "MD039832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.