Jeffrey L Wisnicki, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

ME48094 Issued in FL

Practice address

13005 Southern Blvd Suite 133
Palms West Medical Mall One
Loxahatchee, FL 33470

Phone

(561) 798-1400

Fax

(561) 798-0255

NPI assigned

Oct 26, 2006

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Plastic and Reconstructive Surgery

Education

Stanford University School of Medicine, 1980

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jeffrey Wisnicki, M.D., P.a.

  • Plastic and Reconstructive Surgery Physician
  • Loxahatchee, FL
  • NPI 1265865471
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1154406080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 133",
            "address_2": "PALMS WEST MEDICAL MALL ONE",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709231",
            "telephone_number": "561-798-1400",
            "fax_number": "561-798-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD SUITE 133",
            "address_2": "PALMS WEST MEDICAL MALL ONE",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "33470",
            "telephone_number": "561-798-1400",
            "fax_number": "561-798-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNICKI",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME48094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Wieczorek, LMT
• Lily Wiedrich
• Sparkles Williams, CRNA
• Justin Wimberly, MD
• Wings of an Angel Inc
• Witty Learning Center
• Witty Learning Inc
• Brian Woodside, CIP, ICRC-ADC, CAC,
• Lesa S Wright
• Stacia Wright, PHARM. D.

• Plastic and Reconstructive Surgery Physician in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.
• 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.