Lisa Michelle Wedderburn, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N005519 Issued in NY

Practice address

2146 Beverley Rd
Brooklyn, NY 11226-5406

Phone

(718) 210-3296

Fax

(877) 868-8633

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Advanced Walk-in Foot Care, PLLC

  • Podiatrist
  • Brooklyn, NY
  • NPI 1396762290
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1659398493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E 51ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035902",
            "telephone_number": "917-991-1279",
            "fax_number": "877-868-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 BEVERLEY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112265406",
            "telephone_number": "718-210-3296",
            "fax_number": "877-868-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDERBURN",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02321319",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02519726",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matty Wechsler
• Shoshana R Wechsler, RN
• Ratze Wechter
• Beth Wecksell, PSY.D.
• Dean Ellenore Wedderburn
• Natasha Wedderburn
• Nicole Wedderburn
• Tanisha Wedderburn
• Karen Wedemier, NURSE
• Benjamin Wee, PHARM.D.

• Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.