NPIMap

Individual provider Active NPI

Eric Wilck, MD06291963

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1386632230
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
177095 Issued in NY
Practice address
1176 5TH Ave
New York, NY 10029-6503
Phone
(212) 241-6381
Fax
(212) 410-1973
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 177095 NY Primary

Addresses

Primary practice location

1176 5TH Ave
New York, NY 10029-6503

Mailing address

1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-6381

Other identifiers 1

IdentifierTypeStateIssuer
01213047MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041122001290 NY Practitioner - Diagnostic Radiology 9234194986 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fpa Hospital BasedGroup PAC ID 4789826694, 423 clinicians
Icahn School of Medicine at Mount SinaiGroup PAC ID 4880945955, 33 clinicians
The New York Proton CenterGroup PAC ID 2466780218, 45 clinicians

Practice addresses (Care Compare)

1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-8395

1441 S Ave
Staten Island, NY 10314-3779
Phone (718) 987-9777

2020 Wantagh Ave
Mount Sinai Doctors Wantagh
Wantagh, NY 11793-3931
Phone (516) 961-4545

225 E 126TH St
New York, NY 10035-1406
Phone (646) 968-9064

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai West Hospital, New York, NY, CCN 330046
  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
177095NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Jun 15, 1999 Accepting new patients
Fpa Hospital Based CurrentSince Jun 1, 2013 Accepting new patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Jun 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 30, 2025 Accepting new patients
Fpa Hospital Based Current Accepting new patients
The New York Proton Center CurrentSince Oct 1, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Jun 15, 1999 Accepting new patients

Locations

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

120 New York Ave
Huntington, NY 11743
Phone (631) 351-3766

775 Park Ave
Huntington, NY 11743
Phone (631) 396-1595

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

225 E 126th St
New York, NY 10035
Phone (646) 813-1880

17E E 102nd St
#6D
New York, NY 10029
Phone (212) 241-6381

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

1176 5th Ave
#A
New York, NY 10029
Phone (212) 241-5364

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

1441 South Ave
Staten Island, NY 10314
Phone (332) 243-6900

11 Ralph Pl
Ste 201
Staten Island, NY 10304
Phone (718) 556-6565

2020 Wantagh Ave
Wantagh, NY 11793
Phone (516) 248-2422

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1386632230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-6381",
            "fax_number": "212-410-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-6381",
            "fax_number": "212-410-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCK",
        "first_name": "ERIC",
        "credential": "MD06291963",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "177095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01213047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.