Birute Wise

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

220926 Issued in NY

Practice address

1783 Route 9
Suite 101
Halfmoon, NY 12065-2409

Phone

(518) 371-5437

Fax

(518) 383-6737

NPI assigned

Oct 25, 2006

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Community Care Physicians, PC

  dba Community Care Lab Care

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1023380714
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1437233376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 ROUTE 9",
            "address_2": "SUITE 101",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652409",
            "telephone_number": "518-371-5437",
            "fax_number": "518-383-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "BIRUTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "220926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164863",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Rite Aid)
• Madelyn Rose Weekes, RD, CDN
• Naomi Nicole Wilder, PA-C
• Claire Ellen Williams-Sauer, M.S.ED., CCC-SLP
• Ashley Diane Willson, RD, CDN, CCDES
• With Grace Mental Health Counseling PLLC
• Callista Wlaschin
• Rene Wyman
• Jennifer Kate Yanazzo, M.ED, BCBA/LBA
• Amy M Zimmerman, LMHC-D

• Pediatrics Physician in Halfmoon, NY
• Providers in Halfmoon, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.