Individual provider Active NPI

Ofer Menachem Wellisch, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Stamford, CT
National Provider Identifier
1114189578
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
56314 Issued in CT
Practice address
29 Hospital PLZ
Suite 602
Stamford, CT 06902-3602
Phone
(203) 276-2451
Fax
(203) 276-2452
NPI assigned
Jun 27, 2008
Last updated
May 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 56314 CT Primary

Addresses

Primary practice location

29 Hospital PLZ
Suite 602
Stamford, CT 06902-3602

Mailing address

29 Hospital PLZ
Suite 602
Stamford, CT 06902-3602
Phone (203) 276-2451

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170502000936 CT Practitioner - Pain Management 1557500535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

29 Hospital PLZ
Suite 602
Stamford, CT 06902-3602
Phone (203) 276-4884

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.86
Promoting interoperability
99
Improvement activities
40
Cost
71.31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc CurrentSince May 1, 2017 Accepting new patients
Pain Management and Wellness of Palisades Past Accepting new patients

Locations

75 Holly Hill Ln
Ste 200
Greenwich, CT 06830
Phone (203) 388-5550

75 Holly Hill Ln
Ste 202
Greenwich, CT 06830
Phone (203) 276-4255

29 Hospital Plz
Ste 601
Stamford, CT 06902
Phone (203) 276-2451

29 Hospital Plz
Ste 602
Stamford, CT 06902
Phone (203) 276-2451

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA
  • Direct secure messaging: owellisch24341@stamfordhealth.direct-ci.com

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 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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1114189578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLZ",
            "address_2": "SUITE 602",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-2451",
            "fax_number": "203-276-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLZ",
            "address_2": "SUITE 602",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-2451",
            "fax_number": "203-276-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLISCH",
        "first_name": "OFER",
        "middle_name": "MENACHEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CT",
            "license": "56314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.