Wilfredo Javier Nieves, MD

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

AO54592 Issued in CA

Practice address

1050 W Perimeter Rd
JB Andrews, MD 20762-6601

Phone

(240) 257-8666

NPI assigned

Feb 16, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1366416216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8191 STRAWBERRY LN APT 317",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421047",
            "telephone_number": "719-629-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626601",
            "telephone_number": "240-257-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "WILFREDO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A054592",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "CA",
            "license": "AO54592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Morgan, MA, LPC
• Kent Natapraya, PA-C
• Priya Iyunni Nath, MD
• Raquelle Suzanne Newman, MD
• Nhu-an Thi Nguyen, D.O.
• Jeffrey Notestine
• Rachel O'Reilly
• Nathan Oaks, DO
• Daniel O Olanrewaju, O.D
• Junhyung Park, D.D.S

• Aerospace Medicine Physician in JB Andrews, MD
• Providers in JB Andrews, MD by specialty
• Aerospace Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.