Edward P Wysocki, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1856668 Issued in MA

Practice address

60 Federal St
Boston, MA 02110-2510

Phone

(617) 423-6165

NPI assigned

Jul 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Osorio South Boston Dental Group DMD PC

  • Prosthodontics
  • Boston, MA
  • NPI 1568939163
  NPD (past)
• Watkinosorio Dental Associates

  • Dentist
  • Boston, MA
  • NPI 1790838225
  NPD (past)

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1780091348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 WESTLAND AVE",
            "address_2": "APT 514",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021153827",
            "telephone_number": "617-860-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FEDERAL ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102510",
            "telephone_number": "617-423-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "EDWARD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "1856668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwinna Wynn, MSW
• Michelle Wynn
• Constance Wynne, LICSW
• Julie A Wyrobek, M.D.
• Christina Wysocki, PA-C
• Mikayla D Wysocki, PA-C
• Nicolas Wyvekens, MD
• Cassandra Xanthos, LICSW
• Kathy Xavier
• Ramnik Joseph Xavier, MD

• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.