Individual provider Active NPI

Gary H Wishik, M.D.

  • Anesthesiology Physician
  • Auburn, NY
National Provider Identifier
1619998234
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
173544 Issued in NY
Practice address
17 Lansing St
Auburn, NY 13021-1983
Phone
(315) 255-7204
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 173544 NY Primary

Addresses

Primary practice location

17 Lansing St
Auburn, NY 13021-1983

Mailing address

83 E Genesee St
Skaneateles, NY 13152-1308
Phone (315) 554-8016

Other identifiers 1

IdentifierTypeStateIssuer
01829881MedicaidNY

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
I20040712001163 NY Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9335127737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
New York University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chag Anesthesia PCGroup PAC ID 2668361973, 54 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 498-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173544NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chag Anesthesia PC Anesthesiology CurrentSince Aug 18, 2010 Accepting new patients
Associates for Women'S Medicine PLLC PastSince Feb 13, 2016 Accepting new patients

Locations

4302 Medical Center Dr
Ste 302
Fayetteville, NY 13066
Phone (315) 423-9722

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: gwishik6729@direct.upstate.edu

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 and National Provider Directory roles.

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1619998234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 E GENESEE ST",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521308",
            "telephone_number": "315-554-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHIK",
        "first_name": "GARY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "173544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01829881",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.