Active NPI
Leonard Wisotsky, DPM
- Podiatrist
- Oxon Hill, MD
National Provider Identifier
1265429468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0422
- Practice address
- 6188 Oxon Hill Rd
Ste 804
Oxon Hill, MD 20745-3113 - Phone
- (301) 567-5005
- Fax
- (301) 839-5677
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0422 | MD | Primary |
| Podiatrist | 213E00000X | 290 | DC | |
| Podiatrist | 213E00000X | 373 | VA |
Addresses
Primary practice location
6188 Oxon Hill Rd
Ste 804
Oxon Hill, MD 20745-3113
Mailing address
6188 Oxon Hill Rd
Ste 804
Oxon Hill, MD 20745-3113
Phone (301) 567-5005
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08378 | Other | AMERIGROUP/AMERICAID | |
| 4718680001 | Other | DMERC | |
| 7531019 | Other | AETNA | |
| 2130326 | Other | MAMSI | |
| 521093122 | Other | FIRST HEALTH | |
| 80850001 | Other | BLUE CROSS BLUE SHIELD NC | |
| 036217 | Other | ANTHEM BCBS OF VA | |
| 521093122 | Other | PRUDENTIAL | |
| 36911001 | Other | MD | BLUE CROSS BLUE SHIELD |
| 7020305P | Other | CIGNA PPO | |
| 80850001 | Other | BLUE CROSS BLUE SHIELD FE | |
| 521093122 | Other | GEHA | |
| 602548000 | Medicaid | MD | |
| 81581 | Other | NATIONAL CAPITAL PPO | |
| 27496 | Other | PRIORITY PARTNERS | |
| 493157 | Other | HEALTHLINK NCPPO | |
| 521093122 | Other | MAILHANDLERS | |
| 80850001 | Other | BLUE CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290 | DC | MD | Podiatrist |
| 0422 | MD | MD | Podiatrist |
| 373 | VA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1265429468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6188 OXON HILL RD",
"address_2": "STE 804",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207453113",
"telephone_number": "301-567-5005",
"fax_number": "301-839-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6188 OXON HILL RD",
"address_2": "STE 804",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207453113",
"telephone_number": "301-567-5005",
"fax_number": "301-839-5677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISOTSKY",
"first_name": "LEONARD",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "0422",
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "DC",
"license": "290",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "VA",
"license": "373",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP/AMERICAID",
"identifier": "08378",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "4718680001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7531019",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2130326",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "521093122",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NC",
"identifier": "80850001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS OF VA",
"identifier": "036217",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRUDENTIAL",
"identifier": "521093122",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "36911001",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PPO",
"identifier": "7020305P",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD FE",
"identifier": "80850001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEHA",
"identifier": "521093122",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "602548000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CAPITAL PPO",
"identifier": "81581",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY PARTNERS",
"identifier": "27496",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK NCPPO",
"identifier": "493157",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAILHANDLERS",
"identifier": "521093122",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "80850001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxon Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.