Individual provider Active NPI

Emanuel Wittels, MD

  • Family Medicine Physician
  • Wyomissing, PA
National Provider Identifier
1770577934
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD037171L Issued in PA
Practice address
2610 Keiser Boulevard
Wyomissing, PA 19610-3333
Phone
(610) 775-3316
Fax
(610) 796-2962
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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 MD037171L PA Primary

Addresses

Primary practice location

2610 Keiser Boulevard
Wyomissing, PA 19610-3333

Mailing address

2610 Keiser Boulevard
Wyomissing, PA 19610-3333
Phone (610) 775-3316

Other identifiers 1

IdentifierTypeStateIssuer
0006866610009MedicaidPA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD037171LPAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1770577934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 KEISER BOULEVARD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103333",
            "telephone_number": "610-775-3316",
            "fax_number": "610-796-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 KEISER BOULEVARD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103333",
            "telephone_number": "610-775-3316",
            "fax_number": "610-796-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTELS",
        "first_name": "EMANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD037171L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006866610009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.