Individual provider Active NPI

Michael Craig Wisotsky, PHARMD

  • Ambulatory Care Pharmacist
  • Oakhurst, NJ
National Provider Identifier
1386249266
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
28RI03432600 Issued in NJ
Practice address
246 Norwood Ave
Oakhurst, NJ 07755-1747
Phone
(732) 502-3154
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 1835P2201X 28RI03432600 NJ Primary

Addresses

Primary practice location

246 Norwood Ave
Oakhurst, NJ 07755-1747

Mailing address

1232 Lukas Blvd
Morganville, NJ 07751-9754

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03432600NJMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients
New Jersey CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1386249266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 LUKAS BLVD",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077519754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORWOOD AVE",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077551747",
            "telephone_number": "732-502-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOTSKY",
        "first_name": "MICHAEL",
        "middle_name": "CRAIG",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NJ",
            "license": "28RI03432600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.