Nicolas Wyvekens, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

75 Francis Street Department of Pathology, Brigham and
Boston, MA 02115

Phone

(617) 732-7510

NPI assigned

Jun 5, 2020

Reactivated

Feb 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1477177335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS STREET DEPARTMENT OF PATHOLOGY, BRIGHAM AND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS STREET DEPARTMENT OF PATHOLOGY, BRIGHAM AND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYVEKENS",
        "first_name": "NICOLAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "deactivation_date": "2022-01-18",
        "reactivation_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Wynne, LICSW
• Julie A Wyrobek, M.D.
• Christina Wysocki, PA-C
• Edward P Wysocki, DMD
• Mikayla D Wysocki, PA-C
• Cassandra Xanthos, LICSW
• Kathy Xavier
• Ramnik Joseph Xavier, MD
• Sara Jadsy Xavier
• Lauren Xenakis, CPNP

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.