Individual provider Active NPI

Wildys Rosario, D.O.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1609222165
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31255501 Issued in NY
Practice address
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone
(718) 616-4400
NPI assigned
May 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 31255501 NY Primary

Addresses

Primary practice location

2601 Ocean Pkwy
Brooklyn, NY 11235-7745

Mailing address

1570 E 102ND St Apt 5I
Brooklyn, NY 11236-5906
Phone (347) 489-2914

Other practice location 1

196 Merrick Rd
Family Medicine Residency
Oceanside, NY 11572-1420
Phone (516) 255-8414

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019001450 NY Practitioner - Emergency Medicine 4385032606 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
31255501NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Aug 12, 2021 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
HP Medical Care PC CurrentSince Apr 17, 2023 Accepting new patients

Locations

2083 E 65th St
Brooklyn, NY 11234
Phone (718) 444-5105

2601 Ocean Pkwy
Rm 3N17
Brooklyn, NY 11235
Phone (718) 616-4554

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

2860 W 5th St
Brooklyn, NY 11224
Phone (813) 616-5327

325 Merrick Ave
Ste 3
East Meadow, NY 11554
Phone (516) 855-5880

11620 Queens Blvd
Forest Hills, NY 11375
Phone (718) 401-1510

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631318400000",
    "number": "1609222165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 E 102ND ST APT 5I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365906",
            "telephone_number": "347-489-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Merrick Rd",
            "address_2": "Family Medicine Residency",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721420",
            "country_code": "US",
            "telephone_number": "516-255-8414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "WILDYS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "31255501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.