Individual provider Active NPI

Ian Wert, PA-C

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1720881147
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
033566 Issued in NY
Practice address
3423 Guider Ave
Brooklyn, NY 11235-5271
Phone
(718) 332-4747
NPI assigned
Mar 31, 2025
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 033566 NY Primary

Addresses

Primary practice location

3423 Guider Ave
Brooklyn, NY 11235-5271

Mailing address

3423 Guider Ave
Brooklyn, NY 11235-5271
Phone (718) 332-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250616000464 NY Practitioner - Physician Assistant 5597276766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W Medical Care PCGroup PAC ID 3072898345, 4 clinicians

Practice addresses (Care Compare)

3423 Guider Ave
Brooklyn, NY 11235-5271
Phone (718) 332-4747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
033566NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic W Medical Care PLLC Multi-Specialty Past Accepting new patients

Organizations & group practices 2

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1720881147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 GUIDER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355271",
            "telephone_number": "718-332-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 GUIDER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355271",
            "telephone_number": "718-332-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERT",
        "first_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "033566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.