Active NPI
Don Charles Wukasch, M.D.,FACS,FACC,FACCP
- Psychiatry Physician
- Florence, MA
National Provider Identifier
1306994520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0356
- Practice address
- 92 Main St
Suite 202
Florence, MA 01062-1499 - Phone
- (413) 527-1167
- Fax
- (512) 472-4701
- NPI assigned
- Jan 5, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalysis Psychologist | 103TP0814X | D0356 | TX | |
| Surgery Physician | 208600000X | D0356 | TX | |
| Psychiatry Physician | 2084P0800X | D0356 | TX | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | D0356 | TX |
Addresses
Primary practice location
92 Main St
Suite 202
Florence, MA 01062-1499
Mailing address
500 W 18TH St
Austin, TX 78701-1229
Phone (713) 256-1133
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231167 | Other | MA | MEDICAL STATE LICENSE NUMBER |
| D 0356 | Other | TX | MEDICAL LICENSE NUMBER |
| K0016291 | Other | TX | CON TROLLED SUBSTANCE REGISTRATION |
| MW0858766A | Other | MA | CON TROLLED SUBSTANCE REGISTRATION |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0356 | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334534400000",
"number": "1306994520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W 18TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011229",
"telephone_number": "713-256-1133",
"fax_number": "512-472-4701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 MAIN ST",
"address_2": "SUITE 202",
"city": "FLORENCE",
"state": "MA",
"postal_code": "010621499",
"telephone_number": "413-527-1167",
"fax_number": "512-472-4701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUKASCH",
"first_name": "DON",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "M.D.,FACS,FACC,FACCP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2012-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "TX",
"license": "D0356",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "D0356",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "D0356",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "TX",
"license": "D0356",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL STATE LICENSE NUMBER",
"identifier": "231167",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "D 0356",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CON TROLLED SUBSTANCE REGISTRATION",
"identifier": "K0016291",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CON TROLLED SUBSTANCE REGISTRATION",
"identifier": "MW0858766A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.