Individual provider Active NPI

Jamie Robert Wisser, M.D.

  • Plastic Surgery Physician
  • East Windsor, NJ
National Provider Identifier
1114069671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MA05948 Issued in NJ
Practice address
300B Princeton Hightstown Rd
Ste 101
East Windsor, NJ 08520
Phone
(609) 448-4000
Fax
(609) 426-6995
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MA05948 NJ Primary

Addresses

Primary practice location

300B Princeton Hightstown Rd
Ste 101
East Windsor, NJ 08520

Mailing address

300B Princeton Hightstown Rd
Ste 101
East Windsor, NJ 08520
Phone (609) 448-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080102000427 NJ Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 5799865820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Medical College of Pennsylvania, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 B Princeton Hightstown Rd
East Windsor, NJ 08520-1400
Phone (609) 448-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA05948NJMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Surgical Specialties, P.a. CurrentSince Jun 28, 1994 Accepting new patients
Reliant Surgical Center,LLC PastSince Jul 1, 2009 Accepting new patients

Locations

300B Princeton Hightstown Rd
Ste 101
East Windsor, NJ 08520
Phone (609) 426-9696

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114069671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300B PRINCETON HIGHTSTOWN RD",
            "address_2": "STE 101",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "08520",
            "telephone_number": "609-448-4000",
            "fax_number": "609-426-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300B PRINCETON HIGHTSTOWN RD",
            "address_2": "STE 101",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "08520",
            "telephone_number": "609-448-4000",
            "fax_number": "609-426-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSER",
        "first_name": "JAMIE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "MA05948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, NJ

Sources for this page

Verify at the official NPI Registry.