Individual provider Active NPI

Andrew Stephen Wilantewicz, DPM

  • Podiatrist
  • Wappingers Falls, NY
National Provider Identifier
1457355224
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005494 Issued in NY
Practice address
282 New Hackensack Rd
Wappingers Falls, NY 12590-1402
Phone
(845) 462-8637
Fax
(845) 462-1140
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N005494 NY Primary

Addresses

Primary practice location

282 New Hackensack Rd
Wappingers Falls, NY 12590-1402

Mailing address

282 New Hackensack Rd
Wappingers Falls, NY 12590-1402
Phone (845) 462-8637

Other identifiers 1

IdentifierTypeStateIssuer
02062119MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000500 NY Practitioner - Podiatry 1254543465 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

10421 State Route 40
Granville, NY 12832-5713
Phone (518) 642-2346

282 New Hackensack Rd
Wappingers Falls, NY 12590-1402
Phone (845) 462-8637

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions38
Removal of nail tissue3093
Removal or shaving of skin growth731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005494NYMDMental Health Counselor
N005494NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Director Services PC CurrentSince Aug 1, 2018 Accepting new patients
Mid Hudson Podiatry, PLLC Podiatrist CurrentSince Sep 11, 2001 Accepting new patients
Phase Two Podiatry PC Podiatrist CurrentSince Feb 22, 2018 Accepting new patients
Podiatry Company LLC Podiatrist CurrentSince Dec 1, 2024 Accepting new patients

Locations

620 Sleepy Hollow Rd
Briarcliff Manor, NY 10510
Phone (800) 501-3936

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

10421 State Route 40
Granville, NY 12832
Phone (518) 642-2346

301 Mill Rd
Ste U7
Hewlett, NY 11557

282 New Hackensack Rd
Wappingers Fl, NY 12590
Phone (845) 462-1118

193 S Union Rd
Williamsville, NY 14221
Phone (716) 276-1900

Interoperability endpoints

  • Direct secure messaging: andrewwilantewicz@midhudsonpodiatry.direct.emds.com

Organizations & group practices 5

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1457355224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 NEW HACKENSACK RD",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901402",
            "telephone_number": "845-462-8637",
            "fax_number": "845-462-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 NEW HACKENSACK RD",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901402",
            "telephone_number": "845-462-8637",
            "fax_number": "845-462-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILANTEWICZ",
        "first_name": "ANDREW",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02062119",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

Verify at the official NPI Registry.