William Robert Wiegman, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N004162-1 Issued in NY

Practice address

1034 Carll Dr
Bay Shore, NY 11706-6204

Phone

(631) 665-1614

NPI assigned

May 19, 2007

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609084813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 CARLL DR",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066204",
            "telephone_number": "631-665-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 CARLL DR",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066204",
            "telephone_number": "631-665-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGMAN",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004162-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00966885",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Wheeler, M.S.E.D.
• Amanda Whittaker
• Antonette Julene Whyte-Etere, LCSW-R, CASAC
• Allison Wickers, MA, CCC-SLP
• William Thomas Wiedemann, DO
• Howard R Wigdor
• William Onyebeke MD PC
• Dawn A Williams, CASAC-T
• Julianna Williams, OTR
• Candice Jodyann Williamson, RN

• Podiatrist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.