Active NPI
Edyta Kinga Wisniewska, NP
- Acute Care Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 715683-1
- Practice address
- 173 Fort Washington Ave
New York, NY 10032-3739 - Phone
- (212) 305-2500
- NPI assigned
- Jun 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 715683-1 | NY | |
| Critical Care Medicine Registered Nurse | 163WC0200X | 26NR16881300 | NJ | |
| Acute Care Nurse Practitioner | 363LA2100X | 715683-1 | NY | Primary |
Addresses
Primary practice location
173 Fort Washington Ave
New York, NY 10032-3739
Mailing address
32 Spring St Apt 120
Wallington, NJ 07057-2030
Phone (551) 795-3024
Other practice location 1
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2000 ext. 2576
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W46691947256904 | Other | NJ | DRIVER'S LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Columbia University College of Physicians and Surgeons, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6445 Main St
Suite 2500
Houston, TX 77030-1502
Phone (713) 441-3150
6565 Fannin St
Suite B452
Houston, TX 77030-2703
Phone (713) 441-3620
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR16881300 | NJ | MD | Critical Care Medicine Registered Nurse |
| 715683-1 | NY | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMH Physician Associates PLLC | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| TMH Physician Associates PLLC | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients |
Locations
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494
173 Fort Washington Ave
New York, NY 10032
Phone (212) 305-4600
7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955
6565 Fannin St
Ste B452
Houston, TX 77030
Phone (713) 441-3620
16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- ewisniewska434965@directhoustonmethodist.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 5
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.
-
- Ophthalmology Physician
- Houston, TX
- NPI 1275779225
-
- Otolaryngology Physician
- Houston, TX
- NPI 1902614332
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Orthopaedic Surgery Physician
- Spring, TX
- NPI 1043061351
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cypress, TX
- NPI 1629828405
-
- General Acute Care Hospital
- Houston, TX
- NPI 1871619254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1780114157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 SPRING ST APT 120",
"city": "WALLINGTON",
"state": "NJ",
"postal_code": "070572030",
"telephone_number": "551-795-3024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 FORT WASHINGTON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323739",
"telephone_number": "212-305-2500"
}
],
"practiceLocations": [
{
"address_1": "30 Prospect Ave",
"address_purpose": "LOCATION",
"city": "Hackensack",
"state": "NJ",
"postal_code": "076011915",
"country_code": "US",
"telephone_number": "551-996-2000 x2576",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WISNIEWSKA",
"first_name": "EDYTA",
"middle_name": "KINGA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-18",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NY",
"license": "715683-1",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NJ",
"license": "26NR16881300",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NY",
"license": "715683-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "W46691947256904",
"state": "NJ"
}
],
"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 Oct 3, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.