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ANDREW BENJAMIN WYLIE MD
NPI 1093393365
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since March 30, 2021PECOS Enrolled

NPPES record last updated: June 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2021, Mar 30, 2021 (2 updates tracked since 2021).

About Andrew Benjamin Wylie Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW BENJAMIN WYLIE MD (NPI 1093393365) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093393365
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDREW BENJAMIN WYLIECredential: MD
Location Address55 FRUIT STBoston, MA 02114-2696
Mailing Address9 Hawthorne Pl, Apt 8gBoston, MA 02114-2324 · (914) 772-2013
Phone(914) 772-2013
Sole ProprietorNo
Enumeration DateMarch 30, 2021
Last NPPES UpdateJune 3, 20212 updates tracked since enumeration
NPPES CertifiedJune 3, 2021
✔ NPI 1093393365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Benjamin Wylie Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Wylie's NPI number?

The NPI number for Andrew Wylie is 1093393365. It was assigned to this individual provider in the NPPES registry on March 30, 2021.

Where is Andrew Wylie located?

Andrew Wylie practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (914) 772-2013.

What is Andrew Wylie's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Andrew Wylie enrolled in Medicare?

Yes. Andrew Wylie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrew Wylie was last updated on June 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.