Wisteria Imaging Institute, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WISTERIA IMAGING INSTITUTE, LLC

Practice address

2835 West Cheltenham Ave
Suite 312
Philadelphia, PA 19150

Phone

(860) 262-4489

NPI assigned

Oct 17, 2023

Last updated

Oct 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric Alexander Addo, MD

Title

Owner

Phone

(860) 262-4489

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David S Udis, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1861486409
  NPD
• Vincent Picascio, MD

  • Diagnostic Radiology Physician
  • Naples, FL
  • NPI 1659725323
  NPD
• Kim Truong, MD

  • Diagnostic Radiology Physician
  • La Crosse, WI
  • NPI 1932528387
  NPD

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1255113965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 APALACHEE DR NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022766",
            "telephone_number": "860-262-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 WEST CHELTENHAM AVE",
            "address_2": "SUITE 312",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19150",
            "telephone_number": "860-262-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISTERIA IMAGING INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "ADDO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-262-4489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Wissinger, LCSW
• Wissinoming Medical Associates PC
• Wissinoming Volunteer First Aid Corporation Inc
• Melissa Wissler, MSW, LSW
• Colleen Wister
• Paula Irene Witalec, RPH
• Lucy Jessica Witchell, MD
• James Witek, MD
• Stephanie Witek, PHARMD
• With Compassion Home Care

• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.