NPIMap

Individual provider Active NPI

Alexander Clark Wiseman, MD

  • Transplant Surgery Physician
  • Denver, CO
National Provider Identifier
1033209713
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
DR.0036734 Issued in CO
Practice address
2535 S Downing St Ste 380
Denver, CO 80210-5850
Phone
(303) 778-5797
Fax
(303) 778-5205
NPI assigned
Oct 13, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X DR.0036734 CO Primary
Nephrology Physician 207RN0300X 36734 CO

Addresses

Primary practice location

2535 S Downing St Ste 380
Denver, CO 80210-5850

Mailing address

2535 S Downing St Ste 380
Denver, CO 80210-5850
Phone (303) 778-5797

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other identifiers 1

IdentifierTypeStateIssuer
76882781MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081126000265 CO Practitioner - NephrologyPractitioner - Other (Physician) 4880754480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Washington University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2535 S Downing St
Suite 380
Denver, CO 80210-5850
Phone (303) 778-5797

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36734COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Jul 4, 2020 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

2535 S Downing St
Ste 380
Denver, CO 80210
Phone (303) 260-2740

Networks

  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • CO HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: awiseman1821159@adventhealth.direct-ci.com

Organizations & group practices 4

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

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1033209713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST STE 380",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105850",
            "telephone_number": "303-778-5797",
            "fax_number": "303-778-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST STE 380",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105850",
            "telephone_number": "303-778-5797",
            "fax_number": "303-778-5205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "ALEXANDER",
        "middle_name": "CLARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CO",
            "license": "DR.0036734",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "36734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76882781",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.