Individual provider Active NPI

Jennifer Wisotsky, MD

  • Anesthesiology Physician
  • Mount Kisco, NY
National Provider Identifier
1629212352
Registry record updated Jul 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
243021 Issued in NY
Practice address
400 E Main St
Mount Kisco, NY 10549-3417
Phone
(914) 666-8866
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2024

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 243021 NY Primary

Addresses

Primary practice location

400 E Main St
Mount Kisco, NY 10549-3417

Mailing address

480 Bedford Rd BLDG B
Chappaqua, NY 10514-1715
Phone (914) 666-8866

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
I20101004001283 NY Practitioner - Anesthesiology 2567654999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243021NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Feb 2, 2020 Accepting new patients

Locations

480 Bedford Rd
Bldg B
Chappaqua, NY 10514
Phone (914) 242-9400

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

60 Goldens Bridge Rd
Katonah, NY 10536
Phone (914) 232-1919

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1629212352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BEDFORD RD BLDG B",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105141715",
            "telephone_number": "914-666-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOTSKY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "243021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.