Individual provider Active NPI

Matilda Wissner, M.S.

  • Audiologist
  • New York, NY
National Provider Identifier
1639245038
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1886-1 Issued in NY
Practice address
1305 York Ave
New York, NY 10021-5663
Phone
(646) 962-2231
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1886-1 NY Primary

Addresses

Primary practice location

1305 York Ave
New York, NY 10021-5663

Mailing address

1305 York Ave
New York, NY 10021-5663
Phone (646) 962-2231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070515000061 NY Practitioner - Qualified Audiologist 9931206646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1305 York Ave
Suite 5
New York, NY 10021-5663
Phone (646) 962-4710

156 William St
New York, NY 10038-2609
Phone (646) 962-3686

2315 Broadway
New York, NY 10024-4332
Phone (646) 962-3686

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001886NYMDMarriage & Family Therapist
1886-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Sep 8, 2015 Accepting new patients
Weill Medical College of Cornell CurrentSince Sep 8, 2015 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

2315 Broadway
Frnt 3
New York, NY 10024
Phone (646) 962-5277

1305 York Ave
#5
New York, NY 10021
Phone (212) 746-2281

156 William St
New York, NY 10038
Phone (646) 962-4679

1305 York Ave
New York, NY 10021
Phone (646) 962-2020

1305 York Ave
Fl 5
New York, NY 10021
Phone (646) 962-2231

244 Westchester Ave
Ste 215
White Plains, NY 10604
Phone (646) 438-7802

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1639245038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSNER",
        "first_name": "MATILDA",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "1886-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.