NPIMap

Individual provider Active NPI

Jeffrey William Wike, MD

  • Family Medicine Physician
  • North Syracuse, NY
National Provider Identifier
1659322154
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
239475 Issued in NY
Practice address
792 N Main St Ste 200a
North Syracuse, NY 13212-1673
Phone
(315) 458-8700
Fax
(315) 701-1075
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 239475 NY Primary

Addresses

Primary practice location

792 N Main St Ste 200a
North Syracuse, NY 13212-1673

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060914000061 NY Practitioner - Family Practice 1254335771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Practice addresses (Care Compare)

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

4820 W Taft Rd
Suite 108
Liverpool, NY 13088-4865
Phone (315) 413-0004

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255
  • Nascentia Health at Home Home health agency, Syracuse, NY, CCN 337052
  • HCR Home Care Home health agency, East Syracuse, NY, CCN 337119
  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218
  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239475NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC Family Medicine CurrentSince Jul 17, 2006 Accepting new patients
Your Health Your Choice Dietetics and Nutrition PLLC PastSince Jul 28, 2024 Accepting new patients

Locations

5566 Jordan Rd
Elbridge, NY 13060
Phone (315) 657-3786

4820 W Taft Rd
Ste 108
Liverpool, NY 13088
Phone (315) 413-0004

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

792 N Main St
Ste 200A
Syracuse, NY 13212
Phone (315) 458-8700

Interoperability endpoints

  • Direct secure messaging: jwike@fcmg.medentdirect.com

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 9

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1659322154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-476-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST STE 200A",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121673",
            "telephone_number": "315-458-8700",
            "fax_number": "315-701-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIKE",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "239475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.