Charles Wisniewski, D.O.
Charles Wisniewski, D.O. is a provider specialising in Adolescent and Children Mental Health Clinic/Center in Philadelphia, PA, registered under NPI 1770997587. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 4641 ROOSEVELT BLVD, Philadelphia, PA 19124. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| OS019121 | PA | Psychiatry Physician |
This provider holds licence OS019121 issued in PA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Psychiatry
- PAC ID
- 8123382975
- Enrollment ID
- I20180503001229
Medicare enrolment is recorded as approved under the provider type Practitioner - Psychiatry. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Adolescent and Children Mental Health covers
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. NUCC Health Care Provider Taxonomy, code 261QM0855X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2084P0800X | Psychiatry Physician Psychiatry | OS019121 | PA | |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center Adolescent and Children Mental Health | — | — | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1770997587 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 19, 2014 |
| Last updated | Oct 12, 2018 |
| Status | Active |
| Sole proprietor | Yes |
| Gender | Male |
| Credential | D.O. |
| Practice address |
4641 ROOSEVELT BLVD Philadelphia, PA 19124 (215) 831-2600 |
| Mailing address |
4641 ROOSEVELT BLVD STE E223 Philadelphia, PA 19124 |
| Other names |
Charles Wisniewski Doing Business As |
| Other identifiers |
1770997587
· Medicaid (PA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 7 | 0 | 9 | 9 | 7 | 5 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 5 | 0 | 9 | 9 | 5 | 5 | 7 |
Sum = 73 · next multiple of 10 = 80 · check digit = 7 · actual last digit = 7
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.