Individual provider Active NPI

Kate Anne Wisda

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1710154265
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
648386-1 Issued in NY
Practice address
242 Montrose Ave Apt 2R
Brooklyn, NY 11206-2825
Phone
(626) 840-2362
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 648386-1 NY Primary

Addresses

Primary practice location

242 Montrose Ave Apt 2R
Brooklyn, NY 11206-2825

Mailing address

242 Montrose Ave Apt 2R
Brooklyn, NY 11206-2825
Phone (626) 840-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
648386-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1710154265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MONTROSE AVE APT 2R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062825",
            "telephone_number": "626-840-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MONTROSE AVE APT 2R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062825",
            "telephone_number": "626-840-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDA",
        "first_name": "KATE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "648386-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.