Active NPI
Stanley Wirsig
- Physician Assistant
- New Bedford, MA
National Provider Identifier
1760694434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 903
- Practice address
- 874 Purchase St
Greater New Bedford Community Health Center
New Bedford, MA 02740-6232 - Phone
- (508) 992-6553
- Fax
- (508) 990-7558
- NPI assigned
- May 4, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 903 | MA | Primary |
Addresses
Primary practice location
874 Purchase St
Greater New Bedford Community Health Center
New Bedford, MA 02740-6232
Mailing address
874 Purchase St
New Bedford, MA 02740-6232
Phone (508) 992-6553
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 408335 | Other | RI | BLUE CHIP |
| 32953-2 | Other | RI | BCBSRI |
| 80894 | Other | MA | FALLON |
| 0013376 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 903 | MA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Newburyport, MA
- NPI 1316428824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1760694434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "874 PURCHASE ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027406232",
"telephone_number": "508-992-6553",
"fax_number": "508-990-7558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "874 PURCHASE ST",
"address_2": "GREATER NEW BEDFORD COMMUNITY HEALTH CENTER",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027406232",
"telephone_number": "508-992-6553",
"fax_number": "508-990-7558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRSIG",
"first_name": "STANLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "408335",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSRI",
"identifier": "32953-2",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "80894",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0013376",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.