Organization Active NPI

Wetchler Medical PC

Doing business as Lakeside Concierge Medicine

  • Internal Medicine Physician
  • Woodbury, NY
National Provider Identifier
1154137073
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WETCHLER MEDICAL PC
Doing business as
Lakeside Concierge Medicine
Practice address
135 Crossways Park Dr Ste LL7
Woodbury, NY 11797-2008
Phone
(516) 212-7630
Fax
(516) 200-2482
NPI assigned
Dec 5, 2024
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Dr. Brian Harper Wetchler, DONPI 1710253158
Title
Physician, Owner
Phone
(516) 212-7630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

135 Crossways Park Dr Ste LL7
Woodbury, NY 11797-2008

Mailing address

135 Crossways Park Dr Ste LL7
Woodbury, NY 11797-2008
Phone (516) 212-7630

Other names 1

  • Lakeside Concierge Medicine Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2313732Wetchler Medical PC135 Crossways Park Drive Suite LL7, Woodbury, NY 11797ComplianceDec 10, 2027

National Provider Directory

National Provider Directory

Locations

135 Crossways Park Dr
Ste LL07
Woodbury, NY 11797
Phone (516) 212-7630

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1154137073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 CROSSWAYS PARK DR STE LL7",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972008",
            "telephone_number": "516-212-7630",
            "fax_number": "516-200-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 CROSSWAYS PARK DR STE LL7",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972008",
            "telephone_number": "516-212-7630",
            "fax_number": "516-200-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WETCHLER MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "WETCHLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "HARPER",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "516-212-7630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Concierge Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.