Individual provider Active NPI

Emily Wisniewski, M.D.

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1720519291
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D88789 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201
Phone
(410) 328-6662
NPI assigned
Mar 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D88789 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201

Mailing address

PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181

Other practice location 1

827 Linden Ave Fl 1
Baltimore, MD 21201-4606
Phone (410) 225-8780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428000515 MD Practitioner - Pediatric Medicine 2062787823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince May 22, 2020 Accepting new patients
Maryland Family Care, Inc. Pediatrics CurrentSince Jul 15, 2021 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince May 22, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Maryland Family Care, Inc. PastSince Jul 15, 2021 Accepting new patients

Locations

301 Saint Paul St
Fl 12
Baltimore, MD 21202
Phone (410) 500-5500

827 Linden Ave
Fl 1
Baltimore, MD 21201
Phone (410) 225-8780

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: ewisniewski480687@direct.umm.edu
  • Direct secure messaging: ewisniewski40522@direct.mdmercy.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1720519291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62063",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642063",
            "telephone_number": "410-706-5181",
            "fax_number": "410-706-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-328-6662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "827 Linden Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212014606",
            "country_code": "US",
            "telephone_number": "410-225-8780",
            "fax_number": "410-225-8766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "EMILY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D88789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.