Individual provider Active NPI

Laura Wisniewski

  • Physician Assistant
  • New York, NY
National Provider Identifier
1801585203
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
250 E 73Rd St Apt 20a
New York, NY 10021-4314
Phone
(434) 841-9333
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

250 E 73Rd St Apt 20a
New York, NY 10021-4314

Mailing address

350 W 43Rd St Apt 10F
New York, NY 10036-6469
Phone (434) 841-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213000400 NY Practitioner - Physician Assistant 9739521188 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Physicians of Nyc, PLLC CurrentSince Apr 22, 2024 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients

Locations

420 E 51st St
Ste A
New York, NY 10022
Phone (212) 688-8887

715 9th Ave
New York, NY 10019
Phone (212) 757-2015

Organizations & group practices 6

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1801585203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 43RD ST APT 10F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366469",
            "telephone_number": "434-841-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E 73RD ST APT 20A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214314",
            "telephone_number": "434-841-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.