NPIMap

Individual provider Active NPI

Matthew T Wiza, DO

  • Family Medicine Physician
  • Brockport, NY
National Provider Identifier
1750310348
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
235386 Issued in NY
Practice address
6668 Fourth Section Road
Brockport, NY 14420
Phone
(585) 368-6870
Fax
(585) 368-6871
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 235386 NY Primary

Addresses

Primary practice location

6668 Fourth Section Road
Brockport, NY 14420

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-0553

Other identifiers 1

IdentifierTypeStateIssuer
02641165MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwiza196718@direct.rochesterregional.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000562 NY Practitioner - Family Practice 9032158431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

6668 4TH Section Rd
Brockport, NY 14420-2448
Phone (585) 637-2670

Hospital & facility affiliations

  • HCR / HCR Home Care Chha (Rochester) Home health agency, Rochester, NY, CCN 337257
  • Unity Hospital Hospital, Rochester, NY, CCN 330226
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Family Medicine CurrentSince Feb 12, 2020 Accepting new patients
The Unity Hospital of Rochester CurrentSince Apr 4, 2005 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Western New York Medical Practice P.C CurrentSince Feb 12, 2020 Accepting new patients

Locations

6668 4th Section Rd
Brockport, NY 14420
Phone (585) 368-6870

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Interoperability endpoints

  • Direct secure messaging: mwiza196718@direct.rochesterregional.org

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1750310348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6668 FOURTH SECTION ROAD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "14420",
            "telephone_number": "585-368-6870",
            "fax_number": "585-368-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIZA",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "235386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02641165",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwiza196718@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "6668 Fourth Section Road",
            "city": "Brockport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brockport, NY

Sources for this page

Verify at the official NPI Registry.