DR. WYNN A PERLICK (NPI# 1184714115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184714115 |
| Entity Type | Individual |
| Full Name | DR. WYNN A PERLICK |
| Credential | DPM |
| Practice Address |
111 Willard St Suite 2f Quincy MA 02169-1200 |
| Practice Telephone | 6177732313 |
| Practice Fax Number | 6173283861 |
| Mailing Telephone | 6177732313 |
| Mailing Fax Number | 6173283861 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 2053 | MA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TRICARE | 042297845 | 01 | |
| AETNA | 5297190 | 01 | |
| PHCS | 043376631 | 01 | |
| PHCS/MULTI-PLAN | 042297845 | 01 | |
| GIC | 043376631 | 01 | |
| MA | BLUE CROSS | Y71014 | 01 |
| PRUDENTIAL | 043376631 | 01 | |
| AETNA | 0620074 | 01 | |
| TUFTS | 002053 | 01 | |
| GREAT WEST HEALTH CARE | 042297845 | 01 | |
| FALLON | 1215062 | 01 | |
| GIC/UNICARE | 042297845 | 01 | |
| HARVARD PILGRIM | 33917 | 01 | |
| HCVM/FIRST HEALTH/COVENTY | 042297845 | 01 | |
| UNITED HEALTH CARE | 27 00004 | 01 | |
| HARVARD PILGRIM | 334257 | 01 | |
| MA | BLUE CROSS | Y77182 | 01 |
| TUFTS MEDICARE PREFERRED | 002053 | 01 |
| Street Address |
111 WILLARD ST SUITE 2F |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588650469 | Janna Malamud Smith | Social Worker | 111 Willard St, Quincy, MA 02169-1200 | 2005-09-26 |
| 1700432226 | Haley Stack | Physical Therapist | 111 Willard St, Quincy, MA 02169-1200 | 2019-08-12 |
| 1689122756 | David Kheo Tran | Chiropractor | 111 Willard St, Suite 2a, Quincy, MA 02169-1200 | 2016-09-16 |
| 1588118319 | Ken Tran | Physical Therapist | 111 Willard St, Suite 2a, Quincy, MA 02169-1200 | 2016-08-10 |
| 1164976916 | Kate Moriarty | Physical Therapist | 111 Willard St, Suite 2a, Quincy, MA 02169 | 2016-08-10 |
| 1740674209 | Samantha J Fisk | Physical Therapist | 111 Willard St, Suite 2a, Quincy, MA 02169 | 2015-03-23 |
| 1164831392 | Elyse Harrop | Physical Therapist | 111 Willard St, Ste 2a, Quincy, MA 02169-1200 | 2014-08-13 |
| 1215357546 | Andrea Lui | Physical Therapist | 111 Willard St, Ste 2a, Quincy, MA 02169-1200 | 2014-04-25 |
| 1154673663 | Hannah Miles | Physical Therapist | 111 Willard St, Ste 2a, Quincy, MA 02169-1200 | 2012-10-08 |
| 1306171269 | Joshua D Doty | Chiropractor | 111 Willard St, Suite 2a, Quincy, MA 02169-1200 | 2009-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391186 | Steven Quan | Podiatrist | 70 Wesson Ave, Quincy, MA 02169-7412 | 2017-04-20 |
| 1992816698 | George J Ducach Dpm PC | Podiatrist | 1261 Furnace Brook Parkway, Suite #18, Quincy, MA 02169 | 2006-08-31 |
| 1417957929 | Quincy Family Foot Care, PC | Podiatrist | 3915 Maine St, Suite 5, Quincy, IL 62305-5843 | 2005-07-26 |
| 1033513122 | Unquity Podiatry | Podiatrist | 114 Whitwell St, Quincy, MA 02169-1870 | 2014-10-17 |
| 1396041356 | Boston University General Surgical Associates, Inc.-qmc | Podiatrist | 114 Whitwell St, Quincy, MA 02169-1870 | 2011-02-08 |
| 1497937361 | Reed Foot Clinic | Podiatrist | 601 S 8th St, Quincy, IL 62301-4909 | 2007-12-03 |
| 1518042217 | Dana M Smith Nasiff | Podiatrist | 1261 Furnace Brook Parkway, Suite 18, Quincy, MA 02169 | 2006-10-25 |
| 1942215645 | Foot Care Specialists, P.C. | Podiatrist | 500 Congress St, Suite 1-d, Quincy, MA 02169-0908 | 2006-07-30 |
| 1881629152 | Brennan R Reed | Podiatrist | 601 S 8th St, Quincy, IL 62301 | 2006-07-12 |
| 1124053400 | Shwetal B Patel | Podiatrist | 1118 Hampshire St, Quincy, IL 62301-3027 | 2006-07-12 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.