John R Wittpenn, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

174403 Issued in NY

Practice address

4 Technology Dr
Suite 150
East Setauket, NY 11733-4080

Phone

(631) 941-1400

Fax

(631) 941-1476

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Rockville Centre, NY
  • NPI 1285675660
  Medicare reassignment NPD
• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Stony Brook, NY
  • NPI 1245271600
  NPD

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1154326122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "address_2": "SUITE 150",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-941-1400",
            "fax_number": "631-941-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTPENN",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "174403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01086933",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Britany Chasity Williams
• Daisy Williams, PT
• Jonathan Michael Wilson
• Cheri Wing Kennedy, M.A.,CCC-SLP
• Megan Raines Wingert
• Beth Kimberly Wolf
• Jamie Wolf
• Laura Ann Wolfe McCaffrey, DO
• Sze Kar Wong, PHARM.D.
• Leia Woodruff

• Ophthalmology Physician in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.