JEFFREY SCOTT WISEMAN (NPI# 1235469974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235469974 |
| Entity Type | Individual |
| Full Name | JEFFREY SCOTT WISEMAN |
| Credential | M.D. |
| Practice Address |
30 Harrison St Ste 455 Johnson City NY 13790-2176 |
| Mailing Address |
346 Grand Ave Johnson City NY 13790-2580 |
| Practice Telephone | 6077638100 |
| Practice Fax Number | 6077638048 |
| Mailing Telephone | 6077638100 |
| Mailing Fax Number | 6077638048 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2014-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 190990 | NY | Allopathic & Osteopathic Physicians |
| Y | 208C00000X | Colon & Rectal Surgery | 190990 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01236451 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609497270 | Jeffrey Wiseman | Specialist/Technologist | 1 Ymca Way Ste B, Hampton, VA 23669-3963 | 2020-05-05 |
| Street Address |
30 HARRISON ST STE 455 |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647157 | Ashlin Twardzik | Physician Assistant | 30 Harrison St Ste 455, Johnson City, NY 13790-2176 | 2020-10-22 |
| 1861888711 | Therese Federowicz | Surgery | 30 Harrison St Ste 455, Johnson City, NY 13790-2176 | 2015-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075299 | Colorectal Surgery Services Pllc | Colon & Rectal Surgery | 2200 Northern Blvd Ste 210, Greenvale, NY 11548 | 2017-07-13 |
| 1083157309 | Gadangi Incorporated | Colon & Rectal Surgery | 2583 Ocean Ave Ste 1r, Brooklyn, NY 11229-4575 | 2016-11-18 |
| 1831468966 | Slrhc Faculity Practice | Colon & Rectal Surgery | 425 W 59th St Ste 7b, New York, NY 10019-8022 | 2011-12-19 |
| 1396027207 | Joseph David Mills Jr. | Colon & Rectal Surgery | 1150 Youngs Rd Ste 203, Williamsville, NY 14221-8024 | 2011-09-16 |
| 1386934917 | Giovanni Bonomo | Colon & Rectal Surgery | 256 Mason Ave Bldg C3, Staten Island, NY 10305-3408 | 2011-04-16 |
| 1508189226 | Garden City Colon & Rectal Surgical Practice, P.C. | Colon & Rectal Surgery | 1075 Franklin Ave., Garden City, NY 11530-2930 | 2010-03-09 |
| 1962655167 | Ilya Badalov Physician PC | Colon & Rectal Surgery | 13511 78th Dr, Flushing, NY 11367-3235 | 2008-10-31 |
| 1194981506 | Andre Da Luz Moreira | Colon & Rectal Surgery | 530 1st Ave Ste 7v, New York, NY 10016-6402 | 2008-08-05 |
| 1861671653 | Marian Fleischer | Colon & Rectal Surgery | 9707 Fourth Avenue, Brooklyn, NY 11209 | 2007-10-29 |
| 1710023031 | Advanced Colon and Rectal Surgery LLC | Colon & Rectal Surgery | 510 Broadhollow Road, Suite 307, Melville, NY 11747-3710 | 2007-01-30 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
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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.