Marc A Winiecki, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14578 Issued in NH

Practice address

82 Peterborough St
Jaffrey, NH 03452-5860

Phone

(603) 532-8775

Fax

(603) 532-7482

NPI assigned

Aug 17, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1205940533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 PETERBOROUGH ST",
            "city": "JAFFREY",
            "state": "NH",
            "postal_code": "034525860",
            "telephone_number": "603-532-8775",
            "fax_number": "603-532-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PETERBOROUGH ST",
            "city": "JAFFREY",
            "state": "NH",
            "postal_code": "034525860",
            "telephone_number": "603-532-8775",
            "fax_number": "603-532-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINIECKI",
        "first_name": "MARC",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "14578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "001277301",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30227627",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Spring, OTR
• Mark Joseph Surprenant, OTR/L
• Paul J Theisen
• Heidi Thomas, OTA/L
• Tammy Weeks

• Family Medicine Physician in Jaffrey, NH
• Providers in Jaffrey, NH by specialty
• Family Medicine Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.