Nicholas Charles Wisnoski, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

278799 Issued in NY

Practice address

80 E 11TH Street, Ste#619
New York, NY 10003

Phone

(917) 843-3406

NPI assigned

May 19, 2010

Sex

Male

Sole proprietor

Yes

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

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 Oct 19, 2020 through Oct 19, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1225357072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GRAMERCY PARK S APT 4L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031766",
            "telephone_number": "917-843-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E 11TH STREET, STE#619",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "917-843-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNOSKI",
        "first_name": "NICHOLAS",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-19",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "278799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Wisniewski, AGPCNP
• Thomas Wisniewski, M.D.
• Juan P Wisnivesky, MD
• Sebastian Wisnivesky
• Alexandra Keller Wisnoski, LAC
• Jeffrey H. Wisoff, M.D.
• Jessica Wisotsky
• Karen Joy Wisotsky, M.S.E.D.
• Martine Wisotsky, LCSW
• Rachel Judith Wiss, MSW

• 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 May 31, 2016; 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.