Gloria Diana Wiseman, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

151187 Issued in NY

Practice address

570 Fort Washington Ave
New York, NY 10033-2054

Phone

(212) 795-3293

Fax

(212) 795-3164

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Anesthesiology Physician
  • New York, NY
  • NPI 1477068971
  NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821162801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 EDGEMONT PLACE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664605",
            "telephone_number": "201-837-9918",
            "fax_number": "201-837-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100332054",
            "telephone_number": "212-795-3293",
            "fax_number": "212-795-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "GLORIA",
        "middle_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "151187",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "MA47936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00848417",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5114900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Nicole Wise, PT, DPT
• Quilon Wise, PMHNP-BC
• Tyler Wise, MD
• Wisekidz Learning Solutions of New York, LLC
• Stephen Charles Wisely, PA-C
• Thu Nguyen Wiseman, PA
• Itay Wiser, MD, PHD
• Julian Reed Wiser, EMT, CPHT, MHFA
• Ashleigh Wishen
• Frederick Ben Wishner I, D.C.

• Neonatal-Perinatal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.