Shoukri Mina Wisa, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

170527 Issued in NY

Practice address

164 Washington Ave
Batavia, NY 14020-2113

Phone

(585) 343-6363

Fax

(585) 343-1986

NPI assigned

May 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712

  Internal Medicine

  Medicare reassignment NPD
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment NPD
• United Memorial Medical Center

  • General Acute Care Hospital
  • Batavia, NY
  • NPI 1902800352
  Medicare reassignment NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608

  Internal Medicine

  Medicare reassignment NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD
• United Memorial Medical Center

  • Family Medicine Physician
  • Batavia, NY
  • NPI 1669747085

  Internal Medicine

  NPD
• Orleans Medical PC

  • Medical Specialty Clinic/Center
  • Medina, NY
  • NPI 1689724262
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1306895370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WASHINGTON AVE",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140202113",
            "telephone_number": "585-343-6363",
            "fax_number": "585-343-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WASHINGTON AVE",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140202113",
            "telephone_number": "585-343-6363",
            "fax_number": "585-343-1986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Long Pond Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146261186",
            "country_code": "US",
            "telephone_number": "585-368-4350",
            "fax_number": "585-227-7324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Buffalo Rd Bldg 800",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146241360",
            "country_code": "US",
            "telephone_number": "585-368-6370",
            "fax_number": "585-368-6371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 E Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146212006",
            "country_code": "US",
            "telephone_number": "585-922-4882",
            "fax_number": "585-922-5822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1561 Long Pond Rd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264135",
            "country_code": "US",
            "telephone_number": "585-368-6500",
            "fax_number": "585-368-6501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1561 Long Pond Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264135",
            "country_code": "US",
            "telephone_number": "585-723-7778",
            "fax_number": "585-723-7925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISA",
        "first_name": "SHOUKRI",
        "middle_name": "MINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1705271",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "170527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01127086",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swisa301269@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "1561 Long Pond Rd Ste 303",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146264135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shanda Louise Williams, RN
• Tiffany N Williams, COTA
• Renee Marie Wilmoth, M.A.
• Cynthia L Wilson, MS OTR/L
• Somnit K Wilson, PHARMD
• Jeffrey Leroy Wisley
• Jean Witkowski, RPH
• Wny Pediatric Gastroenterology, PLLC
• Katie Wolcott-Tobias
• Wolverine Hearing Group, LLC

• Hematology & Oncology Physician in Batavia, NY
• Providers in Batavia, NY by specialty
• Hematology & Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.