Active NPI
Wallace John Gasiewicz, M.D.
- Occupational Medicine Physician
- Indianapolis, IN
National Provider Identifier
1972790848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 01059216A
- Practice address
- 10832 Weatherly CT
Indianapolis, IN 46236-8857 - Phone
- (317) 823-9380
- NPI assigned
- Sep 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 01059216A | IN | Primary |
Addresses
Primary practice location
10832 Weatherly CT
Indianapolis, IN 46236-8857
Mailing address
10832 Weatherly CT
Indianapolis, IN 46236-8857
Phone (317) 823-9380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01059216A | IN | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1972790848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10832 WEATHERLY CT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462368857",
"telephone_number": "317-823-9380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10832 WEATHERLY CT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462368857",
"telephone_number": "317-823-9380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASIEWICZ",
"first_name": "WALLACE",
"middle_name": "JOHN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-25",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "IN",
"license": "01059216A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.