Individual provider Active NPI

Michael Witman, MD

  • Neonatal-Perinatal Medicine Physician
  • Poughkeepsie, NY
National Provider Identifier
1225054026
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
226924 Issued in NY
Practice address
45 Reade PL
Poughkeepsie, NY 12601-3947
Phone
(845) 483-6217
Fax
(845) 483-6108
NPI assigned
Jul 14, 2006
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X D92511 MD
Neonatal-Perinatal Medicine Physician 2080N0001X 330198 LA
Neonatal-Perinatal Medicine Physician 2080N0001X 226924 NY Primary

Addresses

Primary practice location

45 Reade PL
Poughkeepsie, NY 12601-3947

Mailing address

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 483-6217

Other identifiers 1

IdentifierTypeStateIssuer
01378481MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220720003804 LA Practitioner - Pediatric Medicine 7315328416 Reassigns benefits to 1 organization
I20260611003617 OR Practitioner - Pediatric Medicine 7315328416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2600 Stearns Way SPC
14A
Medford, OR 97501-1921

2825 E Barnett Rd
Medford, OR 97504-8332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
330198LAMDNeonatal-Perinatal Medicine Physician
D92511MDMDNeonatal-Perinatal Medicine Physician
226924NYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jun 21, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince Jun 21, 2022 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
St. Luke's Cornwall Hospital Past Accepting new patients

Locations

2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650

Networks

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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1225054026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-483-6217",
            "fax_number": "845-483-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-483-6217",
            "fax_number": "845-483-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMAN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MD",
            "license": "D92511",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "LA",
            "license": "330198",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "226924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01378481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.