Active NPI
Tessa Marie Wisniewski, DPT
- Physical Therapist
- South Dennis, MA
National Provider Identifier
1114573359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24368
- Practice address
- 1 Love LN
South Dennis, MA 02660-3445 - Phone
- (508) 385-6034
- NPI assigned
- Aug 14, 2019
- Last updated
- Aug 14, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24368 | MA | Primary |
Addresses
Primary practice location
1 Love LN
South Dennis, MA 02660-3445
Mailing address
80 Thompson Rd
Rochester, NY 14623-4755
Phone (585) 683-1563
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24368 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthosc, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1114573359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 THOMPSON RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146234755",
"telephone_number": "585-683-1563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LOVE LN",
"city": "SOUTH DENNIS",
"state": "MA",
"postal_code": "026603445",
"telephone_number": "508-385-6034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISNIEWSKI",
"first_name": "TESSA",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "24368",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in South Dennis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.