MEDICARE: DR. BENJAMIN MICHAEL WISOTSKY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	D69487	MD
2	2085R0202X	Diagnostic Radiology Physician	TPME5505	FL
3	2085R0202X	Diagnostic Radiology Physician	236247	NY
4	2085R0202X	Diagnostic Radiology Physician	036161592	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TPME5505	OTHER	FL	FLORIDA DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316181092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN MICHAEL WISOTSKY MD

Provider Business Mailing Address
First Line	:	1301 M ST NW
Second Line	:	APT 707
City	:	WASHINGTON
State	:	DC
Zip	:	20005-4201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 MEDICAL PARK DR
Second Line	:	STE 3
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4054
Country	:	US
Telephone Number	:	301-681-3003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	03/09/2026

Similar Medicare Providers

1497720247 — MR. JAMES JAFFE MD
Practice Location Address:

2121 MEDICAL PARK DR , SUITE 1
SILVER SPRING, MD
20902-4054

Practice Phone: 301-681-3003
Practice Fax: 301-681-0889

1891759817 — DANIEL H CLARKE M.D.
Practice Location Address:

2121 MEDICAL PARK DR , SUITE 4
SILVER SPRING, MD
20902-4054

Practice Phone: 301-681-4422
Practice Fax: 301-681-1684

1477519403 — SHEELA D MODIN M.D.
Practice Location Address:

2121 MEDICAL PARK DR , SUITE 4
SILVER SPRING, MD
20902-4054

Practice Phone: 301-681-4422
Practice Fax: 301-681-1684

1952320459 — MRS. TIFANI DAVIS GILLIAM MD
Practice Location Address:

2121 MEDICAL PARK DR , STE 3
SILVER SPRING, MD
20902-4054

Practice Phone: 301-681-3003
Practice Fax:

1497778690 — MRS. LATASHA NICOLE BAXTER CRNP
Practice Location Address:

2121 MEDICAL PARK DR , SUITE 2
SILVER SPRING, MD
20902-4054

Practice Phone: 301-681-3003
Practice Fax:

1902470628 — KATELYN COLLEEN LOPEZ MT-BC
Practice Location Address:

6603 AUGUSTA PINES PKWY E
SPRING, TX
77389-4054

Practice Phone: 801-201-9263
Practice Fax:

Directions to “ DR. BENJAMIN MICHAEL WISOTSKY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.