Individual provider Active NPI

Lisa Wiltse, L.AC., DIPL.AC.

  • Acupuncturist
  • New York, NY
National Provider Identifier
1770275463
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Practice address
43 E 10TH St Apt 6H
New York, NY 10003-6106
Phone
(212) 804-7267
Fax
(212) 518-0578
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

43 E 10TH St Apt 6H
New York, NY 10003-6106

Mailing address

82 Nassau St Ste 208
New York, NY 10038-3703
Phone (620) 353-8487

Other identifiers 1

IdentifierTypeStateIssuer
007338-01OtherNYNY STATE ACUPUNCTURIST LICENSE

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
City Soul Acupuncture, PLLC Acupuncturist CurrentSince Dec 24, 2023 Accepting new patients

Locations

82 Nassau St
New York, NY 10038
Phone (347) 625-3993

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.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1770275463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 NASSAU ST STE 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383703",
            "telephone_number": "620-353-8487",
            "fax_number": "212-518-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 E 10TH ST APT 6H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036106",
            "telephone_number": "212-804-7267",
            "fax_number": "212-518-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSE",
        "first_name": "LISA",
        "credential": "L.AC.,  DIPL.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE ACUPUNCTURIST LICENSE",
            "identifier": "007338-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.