NPIMap

Organization Active NPI

Paul J Wisniewski DO Inc

  • Trauma Surgery Physician
  • Apple Valley, CA
National Provider Identifier
1780433698
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
Legal business name
PAUL J WISNIEWSKI DO INC
Practice address
18523 Corwin Rd Ste a
Apple Valley, CA 92307-2300
Phone
(909) 353-5285
Fax
(909) 752-8719
NPI assigned
May 14, 2024
Last updated
Oct 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Paul WisniewskiNPI 1063674190
Title
DO
Phone
(407) 335-6950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Trauma Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0127X Primary

Addresses

Primary practice location

18523 Corwin Rd Ste a
Apple Valley, CA 92307-2300

Mailing address

18523 Corwin Rd Ste a
Apple Valley, CA 92307-2300
Phone (909) 353-5285

Other practice location 1

450 E Yosemite Ave Ste D
Merced, CA 95340-8429
Phone (350) 225-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241119004099 CA Part B Supplier - Clinic/Group Practice 5092240606 Receives reassigned benefits from 19 practitioners
Practice locations: Apple Valley, CA; Yucaipa, CA

National Provider Directory

National Provider Directory

Locations

450 E Yosemite Ave
Ste D
Merced, CA 95340
Phone (350) 225-3602

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1780433698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18523 CORWIN RD STE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072300",
            "telephone_number": "909-353-5285",
            "fax_number": "909-752-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18523 CORWIN RD STE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072300",
            "telephone_number": "909-353-5285",
            "fax_number": "909-752-8719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Yosemite Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953408429",
            "country_code": "US",
            "telephone_number": "350-225-3602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAUL J WISNIEWSKI DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "WISNIEWSKI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "407-335-6950"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.