Active NPI
Shimshon Wiesel, DO
- Pulmonary Disease Physician
- Lawrence, NY
National Provider Identifier
1346629060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 296931
- Practice address
- 360 Central Ave Ste 113
Lawrence, NY 11559-1604 - Phone
- (516) 569-6966
- NPI assigned
- May 27, 2015
- Last updated
- Jun 17, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 296931 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pulmonary Disease Physician | 207RP1001X | 296931 | NY | Primary |
Addresses
Primary practice location
360 Central Ave Ste 113
Lawrence, NY 11559-1604
Mailing address
360 Central Ave Ste 113
Lawrence, NY 11559-1604
Phone (516) 569-6966
Other practice location 1
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
360 Central Ave
Suite 113
Lawrence, NY 11559-1604
Phone (516) 569-6966
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 22.14 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 73.8
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 296931 | NY | MD | Pulmonary Disease Physician |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- shimshon.wiesel.1@14448.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pulmonary Disease Physician
- Lawrence, NY
- NPI 1750451001
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Rockville Centre, NY
- NPI 1427017854
-
- Rehabilitation Hospital Unit
- Rockville Centre, NY
- NPI 1598724924
-
- General Acute Care Hospital
- Rockville Centre, NY
- NPI 1659330173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1346629060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 CENTRAL AVE STE 113",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591604",
"telephone_number": "516-569-6966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 CENTRAL AVE STE 113",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591604",
"telephone_number": "516-569-6966"
}
],
"practiceLocations": [
{
"address_1": "475 Seaview Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103053436",
"country_code": "US",
"telephone_number": "718-226-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIESEL",
"first_name": "SHIMSHON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-27",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "296931",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "296931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.