NPIMap

Organization Active NPI

Wise Medicine, PC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Kew Gardens, NY
National Provider Identifier
1851695472
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
Legal business name
WISE MEDICINE, PC
Practice address
8403 Cuthbert Rd
Suite 1a
Kew Gardens, NY 11415-2140
Phone
(718) 441-0519
Fax
(718) 441-0554
NPI assigned
Dec 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Authorized official

Name
Dr. Alcibiades J Rodriguez, M.D.
Title
President
Phone
(718) 441-0519

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084S0012X Primary

Addresses

Primary practice location

8403 Cuthbert Rd
Suite 1a
Kew Gardens, NY 11415-2140

Mailing address

8403 Cuthbert Rd
Suite 1a
Kew Gardens, NY 11415-2140
Phone (718) 441-0519

Other identifiers 2

IdentifierTypeStateIssuer
02689334MedicaidNY
86R361OtherEBCBSH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293062400000",
    "number": "1851695472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8403 CUTHBERT RD",
            "address_2": "SUITE 1A",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152140",
            "telephone_number": "718-441-0519",
            "fax_number": "718-441-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8403 CUTHBERT RD",
            "address_2": "SUITE 1A",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152140",
            "telephone_number": "718-441-0519",
            "fax_number": "718-441-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ALCIBIADES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-441-0519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02689334",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EBCBSH",
            "identifier": "86R361",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.