Active NPI
Carla Y Wiles, M.D.
- Family Medicine Physician
- Poughkeepsie, NY
National Provider Identifier
1669464384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 227365
- Practice address
- 488 Freedom Plains Rd
Suite 120
Poughkeepsie, NY 12603-2689 - Phone
- (845) 452-6233
- Fax
- (845) 452-6516
- NPI assigned
- Aug 18, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 227365 | NY | Primary |
Addresses
Primary practice location
488 Freedom Plains Rd
Suite 120
Poughkeepsie, NY 12603-2689
Mailing address
488 Freedom Plains Rd
Suite 120
Poughkeepsie, NY 12603-2689
Phone (845) 452-6233
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001947397 0006 | Medicaid | PA | |
| 2380454 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150514002648 | NY | Order and Referring Only - Family Practice | 2769574169 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Community Hospital | Family Medicine | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Milford, PA
- NPI 1184787731
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454371200000",
"number": "1669464384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 FREEDOM PLAINS RD",
"address_2": "SUITE 120",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032689",
"telephone_number": "845-452-6233",
"fax_number": "845-452-6516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "488 FREEDOM PLAINS RD",
"address_2": "SUITE 120",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032689",
"telephone_number": "845-452-6233",
"fax_number": "845-452-6516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILES",
"first_name": "CARLA",
"middle_name": "Y",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-18",
"last_updated": "2016-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "227365",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001947397 0006",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2380454",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.