Matthew Wisniewski, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

310 Racetrack Rd NW Ste 100
Fort Walton Beach, FL 32547-1553

Phone

(850) 889-4550

NPI assigned

Sep 18, 2018

Last updated

Sep 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12172/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Florida ENT PA

  • Otolaryngology Physician
  • Fort Walton Beach, FL
  • NPI 1821466491
  NPD (past)

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1659855567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 RACETRACK RD NW STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RACETRACK RD NW STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471553",
            "telephone_number": "850-889-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "MATTHEW",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Winblad, PT
• Robert Edward Winkler Jr., ATC
• Anne Wise, L.M.H.C.
• Jessica Wise, M.D.
• Sharon Renee Wise, LMHC
• Andrea J Witt, CRNA
• Gavin Payne Wolfe
• Tade L Wolfe, MA, CCC-SLP
• Vicky Wolfe, PHD
• Megan Wolter, BCBA

• Physical Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.