Individual provider Active NPI

Robert E Wisniewski, M.D.

  • Obstetrics & Gynecology Physician
  • Newark, DE
National Provider Identifier
1487610416
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C10001968 Issued in DE
Practice address
4745 Ogletown Stanton Rd
Suite 106
Newark, DE 19713-2067
Phone
(302) 454-9800
Fax
(302) 454-6446
NPI assigned
Apr 26, 2006
Last updated
Feb 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C10001968 DE Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd
Suite 106
Newark, DE 19713-2067

Mailing address

4735 Ogletown Stanton Rd
Suite 1109
Newark, DE 19713-2072
Phone (302) 454-9800

Other identifiers 4

IdentifierTypeStateIssuer
00079364000OtherAMERIHEALTH
B66433OtherDEBLUE CROSS BLUE SHIELD
304498OtherDECOVENTRY
4281681OtherAETNA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10001861DEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First State Women's Care, P.a. Obstetrics & Gynecology CurrentSince Sep 22, 2008 Accepting new patients
Christiana Center for Womens Wellness, P,a. Past Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 109
Newark, DE 19713

4735 Ogletown Stanton Rd
Ste 1109
Newark, DE 19713
Phone (302) 454-9800

4745 Ogletown Stanton Rd
Ste 106
Newark, DE 19713
Phone (302) 454-9800

19 West Ave
#B
Woodstown, NJ 08098
Phone (856) 769-3348

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1487610416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "SUITE 1109",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-454-9800",
            "fax_number": "302-454-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 106",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132067",
            "telephone_number": "302-454-9800",
            "fax_number": "302-454-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "DE",
            "license": "C10001968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "00079364000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "B66433",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "304498",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4281681",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.