Individual provider Active NPI

Ellen Barbara Wetter, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1881612448
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
158090 Issued in NY
Practice address
227 Madison St
New York, NY 10002-7537
Phone
(212) 238-7512
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 158090 NY Primary

Addresses

Primary practice location

227 Madison St
New York, NY 10002-7537

Mailing address

196 E 75TH St Apt 21C
New York, NY 10021-3266
Phone (212) 535-2557

Other identifiers 1

IdentifierTypeStateIssuer
00946438MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090930000138 NY Practitioner - Diagnostic Radiology 4486790714 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
158090NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 1, 2012 Accepting new patients
New York University CurrentSince Dec 1, 2012 Accepting new patients
Nyumc Radiology Associates Diagnostic Radiology Past Accepting new patients
New York University Medical Center Faculty Practice Radiology Diagnostic Radiology Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

221 Lexington Ave
New York, NY 10016
Phone (212) 731-5002

1901 1st Ave
Rm 1608
New York, NY 10029
Phone (212) 230-6586

227 Madison St
New York, NY 10002
Phone (212) 238-7000

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

560 1st Ave
Fl 2
New York, NY 10016
Phone (212) 263-5212

660 1st Ave
New York, NY 10016
Phone (212) 263-0001

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1881612448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 E 75TH ST APT 21C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213266",
            "telephone_number": "212-535-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MADISON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027537",
            "telephone_number": "212-238-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTER",
        "first_name": "ELLEN",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "158090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00946438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.