Active NPI
Walter Wissler
- Student in an Organized Health Care Education/Training Program
- Brighton, MA
National Provider Identifier
1184365876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 736 Cambridge St
Brighton, MA 02135-2907 - Phone
- (617) 789-3000
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
736 Cambridge St
Brighton, MA 02135-2907
Mailing address
738 New St
Camden, NJ 08103-1524
Phone (732) 682-2377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221101002079 | MA | Order and Referring Only - Anesthesiology | 8325415557 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- wwissler259861@direct.bmc.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1184365876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 NEW ST",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031524",
"telephone_number": "732-682-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "617-789-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISSLER",
"first_name": "WALTER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.