Individual provider Active NPI

Steven Wiese, MD

  • Emergency Medicine Physician
  • Odessa, TX
National Provider Identifier
1003075532
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P7870 Issued in TX
Practice address
4236 E Everglade Ave
Odessa, TX 79762-7136
Phone
(979) 575-8119
NPI assigned
Jun 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P7870 TX Primary

Addresses

Primary practice location

4236 E Everglade Ave
Odessa, TX 79762-7136

Mailing address

4236 E Everglade Ave
Odessa, TX 79762-7136
Phone (979) 575-8119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002000356 TX Practitioner - Emergency Medicine 1759501323 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

200 S Geneva St
Breckenridge, TX 76424-4702
Phone (254) 559-2241

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P7870TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Muenster Hospital District Emergency Medicine CurrentSince Aug 21, 2014 Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine CurrentSince Sep 2, 2014 Accepting new patients
Muenster Hospital District CurrentSince Aug 21, 2014 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Feb 1, 2016 Accepting new patients
Frio Hospital Association CurrentSince Aug 27, 2014 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Feb 1, 2016 Accepting new patients
Frio Hospital Association Emergency Medicine CurrentSince Aug 27, 2014 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

704 Hospital Dr
Carrizo Springs, TX 78834
Phone (830) 876-2424

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

605 N Maple St
Muenster, TX 76252
Phone (940) 759-2271

151 Medical Dr
Pearsall, TX 78061
Phone (830) 334-4126

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a7e8884c-0f8a-4040-a7e2-b8409572d6c9/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1003075532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4236 E EVERGLADE AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627136",
            "telephone_number": "979-575-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4236 E EVERGLADE AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627136",
            "telephone_number": "979-575-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P7870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.