Active NPI
Mitchell Albert Wick, DO
- Internal Medicine Physician
- Boynton Beach, FL
National Provider Identifier
1720164353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 054327
- Practice address
- 3795 West Boynton Beach Blvd
Walk in Family Medicine Center
Boynton Beach, FL 33436 - Phone
- (561) 736-2001
- Fax
- (561) 736-2002
- NPI assigned
- Oct 27, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 054327 | FL | Primary |
Addresses
Primary practice location
3795 West Boynton Beach Blvd
Walk in Family Medicine Center
Boynton Beach, FL 33436
Mailing address
914 S Chippewa Cir
Boynton Beach, FL 33436
Phone (984) 612-5034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OS4327 | Other | FL | LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054327 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1720164353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 S CHIPPEWA CIR",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "33436",
"telephone_number": "984-612-5034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3795 WEST BOYNTON BEACH BLVD",
"address_2": "WALK IN FAMILY MEDICINE CENTER",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "33436",
"telephone_number": "561-736-2001",
"fax_number": "561-736-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICK",
"first_name": "MITCHELL",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "054327",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "OS4327",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.