Individual provider Active NPI

Marta Wesolowski, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1366690208
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11014548A Issued in IN
Practice address
1520 N Senate Ave
Indianapolis, IN 46202-2213
Phone
(317) 962-8893
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11014548A IN Primary

Addresses

Primary practice location

1520 N Senate Ave
Indianapolis, IN 46202-2213

Mailing address

1520 N Senate Ave
Indianapolis, IN 46202-2213
Phone (317) 962-8893

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

LicenseStateTypeSpecialty
11014548AINMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1366690208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N SENATE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022213",
            "telephone_number": "317-962-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N SENATE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022213",
            "telephone_number": "317-962-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESOLOWSKI",
        "first_name": "MARTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11014548A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.