Wise Mind Living Psychiatry PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WISE MIND LIVING PSYCHIATRY PC

Practice address

330 W 58TH St Ste 313
New York, NY 10019-1821

Phone

(212) 579-3639

Fax

(917) 725-8234

NPI assigned

Oct 27, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mark William Wilson, MDNPI 1285632794

Title

Owner

Phone

(212) 579-3639

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark William Wilson, MD

  • Psychiatry Physician
  • New York, NY
  • NPI 1285632794
  NPD Authorized official

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1174123327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 313",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191821",
            "telephone_number": "212-579-3639",
            "fax_number": "917-725-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 313",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191821",
            "telephone_number": "212-579-3639",
            "fax_number": "917-725-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND LIVING PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-579-3639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WE DO NOT ACCEPT INSURANCE",
            "identifier": "5862037",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.centerforwisemindliving.com",
            "affiliation": "N",
            "endpointDescription": "Webpage and business level, HIPAA-compliant Gmail/email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Exchange email",
            "address_1": "330 W 58th St Ste 313",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100191821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Wisch, MD
• Cheryl A Wischhover, RN
• Shannon Wischusen
• Wisdom House New York, Inc.
• Wise Body Physical Therapy, PLLC
• Brittany Kaitlin Wise-Oringer, MD
• Abigail Jane Wise
• Adina Wise, MD
• Bonnie Elizabeth Wise, ANP-BC
• Brent R Wise, MD

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.