Organization Active NPI

Kidney and Hypertension Consultant, PLLC

  • Nephrology Physician
  • Utica, NY
National Provider Identifier
1699796623
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
207857 Issued in NY
Legal business name
KIDNEY AND HYPERTENSION CONSULTANT, PLLC
Practice address
1676 Sunset Ave
Suite 401
Utica, NY 13502-5416
Phone
(315) 624-8100
Fax
(315) 624-8105
NPI assigned
Jul 23, 2006
Last updated
Feb 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Authorized official

Name
Emile Wassel, M.D.NPI 1023047552
Title
Physician
Phone
(315) 624-8100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 207857 NY Primary

Addresses

Primary practice location

1676 Sunset Ave
Suite 401
Utica, NY 13502-5416

Mailing address

P.O. Box 602
New Hartford, NY 13413

Other identifiers 1

IdentifierTypeStateIssuer
02902963MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000425 NY Part B Supplier - Clinic/Group Practice 7911991955 Receives reassigned benefits from 7 practitioners
Practice locations: Utica, NY; Rome, NY; Oneida, NY; Norwich, NY; New Hartford, NY; Lowrille, NY; Herkimer, NY; Hamilton, NY

National Provider Directory

National Provider Directory

Locations

2142 Glenwood Shopping Plz
Oneida, NY 13421
Phone (315) 363-1393

111 E Chestnut St
Ste 2
Rome, NY 13440
Phone (315) 624-9004

117 Erie Blvd W
Rome, NY 13440
Phone (315) 306-3337

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

1676 Sunset Ave
Ste 401
Utica, NY 13502
Phone (315) 624-8100

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1699796623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 602",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "13413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "address_2": "SUITE 401",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025416",
            "telephone_number": "315-624-8100",
            "fax_number": "315-624-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND HYPERTENSION CONSULTANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "WASSEL",
        "authorized_official_first_name": "EMILE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "315-624-8100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "207857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02902963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.