Wouter J Rietsema, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

195737 Issued in NY

Practice address

75 Beekman St
Plattsburgh, NY 12901-1438

Phone

(518) 561-2000

Fax

(518) 561-0881

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Lake Champlain Physician Services

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1083915268
  NPD (past) Authorized official
• Champlain Valley Physicians Hospital Medical Center

  • Skilled Nursing Facility
  • Plattsburgh, NY
  • NPI 1215098876
  NPD (past)
• Champlain Valley Physicians Hospital Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Plattsburgh, NY
  • NPI 1487785382
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1699832535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010259",
            "telephone_number": "518-562-7900",
            "fax_number": "518-562-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-561-2000",
            "fax_number": "518-561-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIETSEMA",
        "first_name": "WOUTER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "195737",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "195737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF NENY",
            "identifier": "000405209002",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01561260",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "119037",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7423705",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "044661958",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "09004310",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "141338471",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS UTICA WATERTOWN",
            "identifier": "P010195737",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "141338471",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "114406",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "440002865",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florence Reynaud, L.AC.
• Doris Rible Lacy, SLP
• Richard Webber
• Susan Louise Richards, M.A., SLP/CCC
• Kevin Richardson
• Jacqueline Beth Riley, NP
• Hannah Riney, LMSW
• Krista Ringer
• Joseph Anthony Rini, M.D.
• Keith A Ritchie, CASAC

• Infectious Disease Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Infectious Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.