Individual provider Active NPI

Heather L Wasileski, D.O.

  • Internal Medicine Physician
  • Auburn, NY
National Provider Identifier
1760458855
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
234048 Issued in NY
Practice address
77 Nelson St
Suite 310
Auburn, NY 13021-1944
Phone
(315) 253-4463
Fax
(315) 253-5624
NPI assigned
Feb 27, 2006
Last updated
Nov 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14577 NH
Internal Medicine Physician 207R00000X 234048 NY Primary

Addresses

Primary practice location

77 Nelson St
Suite 310
Auburn, NY 13021-1944

Mailing address

77 Nelson St
Suite 310
Auburn, NY 13021-1945
Phone (315) 253-4463

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716000017 NY Practitioner - Internal Medicine 5193871788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians

Practice addresses (Care Compare)

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14577NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC Internal Medicine CurrentSince Nov 12, 2017 Accepting new patients

Locations

37 W Garden St
Ste 102
Auburn, NY 13021
Phone (315) 282-0525

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Interoperability endpoints

  • Direct secure messaging: hwasileski@fcmg.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1760458855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NELSON ST",
            "address_2": "SUITE 310",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211945",
            "telephone_number": "315-253-4463",
            "fax_number": "315-253-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NELSON ST",
            "address_2": "SUITE 310",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211944",
            "telephone_number": "315-253-4463",
            "fax_number": "315-253-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASILESKI",
        "first_name": "HEATHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "14577",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.