SHOUKRI MINA WISA MD
NPI 1306895370
Internal Medicine - Hematology & Oncology in Batavia, NY

Q: What is Shoukri Wisa's NPI number?

The NPI number for Shoukri Wisa is 1306895370. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Q: What is Shoukri Wisa's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Shoukri Wisa was last updated on April 28, 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.

Active since May 08, 2006PECOS Enrolled

164 WASHINGTON AVE, BATAVIA, NY 14020(585) 343-6363(585) 343-1986 Get Directions Write a Review

NPPES record last updated: April 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 28, 2021, Feb 3, 2020 (2 updates tracked since 2020).

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About Shoukri Mina Wisa Md NPPES

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

SHOUKRI MINA WISA MD (NPI 1306895370) is an individual hematology & oncology provider in Batavia, New York, licensed in New York (170527) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1306895370

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameSHOUKRI MINA WISACredential: MD

Location Address164 WASHINGTON AVEBatavia, NY 14020-2113

Mailing Address164 Washington AveBatavia, NY 14020-2113 · (585) 343-6363 · Fax (585) 343-1986

Phone(585) 343-6363

Fax(585) 343-1986

Sole ProprietorNo

Enumeration DateMay 8, 2006

Last NPPES UpdateApril 28, 20212 updates tracked since enumeration

NPPES CertifiedApril 28, 2021

✔ NPI 1306895370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in NY · 170527

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedInternal MedicineTaxonomy 207R00000X · License 1705271 (NY)

164 WASHINGTON AVE, Batavia, NY 14020

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Secondary Practice Locations 5

Location 11100 Long Pond Rd Ste 250Rochester, NY 14626-1186 · Phone (585) 368-4350 · Fax (585) 227-7324

Location 22300 Buffalo Rd Bldg 800Rochester, NY 14624-1360 · Phone (585) 368-6370 · Fax (585) 368-6371

Location 31455 E Ridge RdRochester, NY 14621-2006 · Phone (585) 922-4882 · Fax (585) 922-5822

Location 41561 Long Pond Rd Ste 303Rochester, NY 14626-4135 · Phone (585) 368-6500 · Fax (585) 368-6501

Location 51561 Long Pond Rd Ste 202Rochester, NY 14626-4135 · Phone (585) 723-7778 · Fax (585) 723-7925

Other Identifiers 1

Medicaid01127086NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shoukri Mina Wisa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14020 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$166.88 typical visit price

range $54.87 – $166.88

Typical copayment $41.72 (range $13.71 – $41.72)

Most-billed visit code 99205

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

MS. PATRICIA BONCZYK NP

Nurse Practitioner (Adult Health)