Individual provider Active NPI

Danielle Tara Wisniewski, M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1619339777
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A150742 Issued in CA
Practice address
300 Hillmont Ave
Ventura, CA 93003-1651
Phone
(805) 652-6556
Fax
(805) 652-3252
NPI assigned
Mar 27, 2016
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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
Family Medicine Physician 207Q00000X A150742 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
Ventura, CA 93003-1651

Mailing address

800 S Victoria Ave, L4615
Vchca - Physician Services
Ventura, CA 93009-0003
Phone (805) 677-5181

Other practice location 1

3569 Round Barn Cir
Suite 200
Santa Rosa, CA 95403-5781
Phone (707) 583-8800

Other practice location 2

3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671
Phone (707) 303-3600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address danielle.wisniewski@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190927001907 CA Practitioner - Family Practice 2567713928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651
Phone (805) 654-3306

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
64.51
Promoting interoperability
100
Improvement activities
40
Cost
72.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150742CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Aug 13, 2019 Accepting new patients
County of Ventura CurrentSince Aug 13, 2019 Accepting new patients
County of Ventura Current Accepting new patients
County of Ventura Current Accepting new patients
Sutter West Bay Medical Foundation Family Medicine Past Accepting new patients
Planned Parenthood California Central Coast Past Accepting new patients

Locations

518 Garden St
Santa Barbara, CA 93101
Phone (805) 963-2445

825 N 10th St
Santa Paula, CA 93060
Phone (805) 933-8600

254 W Harvard Blvd
Ste B
Santa Paula, CA 93060
Phone (805) 229-0200

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

800 S Victoria Ave
#L4640
Ventura, CA 93009

800 S Victoria Ave
#L4615
Ventura, CA 93009
Phone (805) 677-5181

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Organizations & group practices 6

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": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1619339777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S VICTORIA AVE, L4615",
            "address_2": "VCHCA - PHYSICIAN SERVICES",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930090003",
            "telephone_number": "805-677-5181",
            "fax_number": "805-677-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6556",
            "fax_number": "805-652-3252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3569 Round Barn Cir",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954035781",
            "country_code": "US",
            "telephone_number": "707-583-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3883 Airway Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031671",
            "country_code": "US",
            "telephone_number": "707-303-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "DANIELLE",
        "middle_name": "TARA",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-27",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A150742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danielle.wisniewski@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.