Active NPI
Brian Wasicek
- Student in an Organized Health Care Education/Training Program
- Farmington, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 263 Farmington Ave
Farmington, CT 06030-1410 - Phone
- (860) 679-4733
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 72791 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
263 Farmington Ave
Farmington, CT 06030-1410
Mailing address
263 Farmington Ave
Farmington, CT 06030-1410
Phone (860) 679-4733
Other practice location 1
326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- F H Netter, M.D. School of Med at Quinnipiac Univ, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988
Hospital & facility affiliations
- Evergreenhealth Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.73 of 100
- Quality
- 73.46
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King County Public Hospital District No. 2 | Current | Accepting new patients | |
| King County Public Hospital District No 2 | Current | Accepting new patients | |
| King County Public Hospital District No 2 | Current | Accepting new patients | |
| The William W Backus Hospital | Current | Accepting new patients | |
| King County Public Hospital District No. 2 | Current | Accepting new patients | |
| King County Public Hospital District No 2 | Past | Accepting new patients |
Locations
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988
14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889
12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894
Interoperability endpoints
- brian.wasicek@xdr.hhchealthdirect.org
Organizations & group practices 6
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.
-
- Neuromusculoskeletal Medicine & OMM Physician
- Kirkland, WA
- NPI 1801986070
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- Family Medicine Physician
- Bothell, WA
- NPI 1902907165
-
- Physical Therapist
- Kirkland, WA
- NPI 1356920946
-
- Clinic/Center
- Redmond, WA
- NPI 1750612883
-
- Obstetrics Physician
- Kirkland, WA
- NPI 1891883435
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kirkland, WA
- NPI 1033174933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1699304121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060301410",
"telephone_number": "860-679-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060301410",
"telephone_number": "860-679-4733"
}
],
"practiceLocations": [
{
"address_1": "326 Washington St",
"address_purpose": "LOCATION",
"city": "Norwich",
"state": "CT",
"postal_code": "063602740",
"country_code": "US",
"telephone_number": "860-889-8331",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WASICEK",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-06",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "72791",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.