Organization Active NPI

Marc E Wietschner MD P C

  • Ophthalmology Physician
  • Floral Park, NY
National Provider Identifier
1326248808
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARC E WIETSCHNER MD P C
Practice address
342 Jericho Tpke
Floral Park, NY 11001-2108
Phone
(516) 354-2020
Fax
(516) 354-0400
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Authorized official

Name
Dr. Marc E. Wietschner, MDNPI 1477555829
Title
Doctor
Phone
(516) 354-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

342 Jericho Tpke
Floral Park, NY 11001-2108

Mailing address

342 Jericho Tpke
Floral Park, NY 11001-2108
Phone (516) 354-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080606000743 NY Part B Supplier - Clinic/Group Practice 4587734280 Receives reassigned benefits from 2 practitioners
Practice locations: Floral Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1326248808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012108",
            "telephone_number": "516-354-2020",
            "fax_number": "516-354-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012108",
            "telephone_number": "516-354-2020",
            "fax_number": "516-354-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC E WIETSCHNER MD P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "WIETSCHNER",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "516-354-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.