Individual provider Active NPI

John S Wisniewski, MD

  • Internal Medicine Physician
  • Hartford, CT
National Provider Identifier
1689786568
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
046333 Issued in CT
Practice address
85 Seymour St
Suite 900
Hartford, CT 06106-5501
Phone
(860) 241-0700
Fax
(860) 525-7881
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046333 CT Primary

Addresses

Primary practice location

85 Seymour St
Suite 900
Hartford, CT 06106-5501

Mailing address

2110 Silas Deane Hwy
Rocky Hill, CT 06067-2313
Phone (860) 258-3470

Other identifiers 1

IdentifierTypeStateIssuer
046333OtherCTLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000174 CT Practitioner - Internal Medicine 3678644838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

Practice addresses (Care Compare)

1260 Silas Deane Hwy
Wethersfield, CT 06109-4362
Phone (860) 832-4666

Hospital & facility affiliations

  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Atrinity Home Health Home health agency, Wallingford, CT, CCN 077254
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046333CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
Starling Physicians PLLC CurrentSince Jul 1, 2008 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

533 Cottage Grove Rd
Bloomfield, CT 06002
Phone (860) 696-2820

1345 Farmington Ave
Bristol, CT 06010
Phone (860) 585-0000

11 South Rd
Farmington, CT 06032
Phone (860) 522-7121

85 Seymour St
Ste 900
Hartford, CT 06106
Phone (860) 241-0700

2110 Silas Deane Hwy
Rocky Hill, CT 06067

1260 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 258-3477

1260 Silas Deane Hwy
Ste 106
Wethersfield, CT 06109
Phone (860) 258-3477

1210 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 721-5731

Interoperability endpoints

  • Direct secure messaging: john.wisniewski@xdr.hhchealthdirect.org

Organizations & group practices 4

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 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1689786568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672313",
            "telephone_number": "860-258-3470",
            "fax_number": "860-571-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 900",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-241-0700",
            "fax_number": "860-525-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "046333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "046333",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.