Individual provider Active NPI

Norman Wiesenthal, M.D.

  • Family Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1619901022
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME30475 Issued in FL
Practice address
3860 Saint James CT
Boca Raton, FL 33434-3368
Phone
(954) 655-4815
NPI assigned
Jul 10, 2006
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME30475 FL Primary

Addresses

Primary practice location

3860 Saint James CT
Boca Raton, FL 33434-3368

Mailing address

3860 Saint James CT
Boca Raton, FL 33434-3368
Phone (954) 655-4815

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Care LLC Family Medicine Past Accepting new patients

Organizations & group practices 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1619901022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 SAINT JAMES CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343368",
            "telephone_number": "954-655-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 SAINT JAMES CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343368",
            "telephone_number": "954-655-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESENTHAL",
        "first_name": "NORMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME30475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.