Individual provider Active NPI

Michael J Wiewiorski, PA

  • Physician Assistant
  • Niagara Falls, NY
National Provider Identifier
1669636460
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012796 Issued in NY
Practice address
3117 Military Rd
Niagara Falls, NY 14304-4813
Phone
(716) 257-1254
Fax
(716) 215-6170
NPI assigned
Jul 11, 2008
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03610 NC
Physician Assistant 363A00000X 012796 NY Primary

Addresses

Primary practice location

3117 Military Rd
Niagara Falls, NY 14304-4813

Mailing address

3117 Military Rd
Niagara Falls, NY 14304-4813
Phone (716) 257-1254

Other practice location 1

5893 Camp Rd Ste 3
Hamburg, NY 14075-4470
Phone (716) 257-1254

Other practice location 2

901 Wayne St
Olean, NY 14760-2255
Phone (716) 257-1254

Other identifiers 2

IdentifierTypeStateIssuer
000530695001OtherNYBLUE CROSS WNY
9515265OtherNYINDEPENDENT HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwiewiorski404790@direct.novanthealth.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000871 NY Practitioner - Physician Assistant 5799845723 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03610NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Aug 5, 2024 Accepting new patients
Rochester General Hospital CurrentSince Aug 5, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Aug 5, 2024 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Mar 13, 2023 Accepting new patients
Rochester General Hospital CurrentSince Aug 5, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Aug 5, 2024 Accepting new patients
Genesee Valley Group Health Association Past Accepting new patients
FDR Medical Services P.C. Past Accepting new patients
Starmed Urgent & Family Care, P.a. Physician Assistant PastSince Dec 1, 2019 Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

3980 Sheridan Dr
Snyder, NY 14226
Phone (716) 929-2800

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1669636460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 MILITARY RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143044813",
            "telephone_number": "716-257-1254",
            "fax_number": "716-215-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 MILITARY RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143044813",
            "telephone_number": "716-257-1254",
            "fax_number": "716-215-6170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5893 Camp Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "NY",
            "postal_code": "140754470",
            "country_code": "US",
            "telephone_number": "716-257-1254",
            "fax_number": "716-215-6170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Wayne St",
            "address_purpose": "LOCATION",
            "city": "Olean",
            "state": "NY",
            "postal_code": "147602255",
            "country_code": "US",
            "telephone_number": "716-257-1254",
            "fax_number": "716-215-6170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEWIORSKI",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03610",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WNY",
            "identifier": "000530695001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9515265",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwiewiorski404790@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9600 E Independence Blvd",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281054628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.