Corey Ilyssa Wasserman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

271434 Issued in NY

Practice address

40 Worth St
Suite 402
New York, NY 10013-2904

Phone

(646) 962-3400

NPI assigned

Jun 16, 2011

Last updated

Mar 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Corey Ilyssa Waxman Former name

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

• Direct secure messaging: ciw9002@direct.nyp.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Weill Medical College of Cornell

  • Internal Medicine Physician
  • New York, NY
  • NPI 1124170212

  Pediatrics

  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell University

  • Internal Medicine Physician
  • New York, NY
  • NPI 1487933081

  Pediatrics

  NPD
• Greenwich OB/GYN Medical P.C.

  • Specialist
  • New York, NY
  • NPI 1124002027
  NPD (past)
• Weill Cornell University Medical College

  • Women's Hospital
  • New York, NY
  • NPI 1538141536
  NPD (past)
• Weill Medical College of Cornell

  dba Weill Cornell Medical Associates

  • Internal Medicine Physician
  • New York, NY
  • NPI 1417990649
  NPD (past)

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1922393008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WORTH ST",
            "address_2": "SUITE 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132904",
            "telephone_number": "646-962-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WORTH ST",
            "address_2": "SUITE 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132904",
            "telephone_number": "646-962-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "COREY",
        "middle_name": "ILYSSA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "271434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COREY",
            "last_name": "WAXMAN",
            "middle_name": "ILYSSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walter Gabriel Wasser, MD
• Macie Wasserberger
• Amanda Wasserman, PA-C
• Barbara E Wasserman, LMSW
• Bradley Ross Wasserman, M.D.
• Emily Beth Wasserman, M.D.
• Gregory Alexander Wasserman, DO, PHD
• Howard Jay Wasserman, D.D.S.
• Judith G Wasserman, OTR/L
• Lauren Wasserman, DPM

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.