Individual provider Active NPI

Morgan M Wise, D.O.

  • Emergency Medicine Physician
  • Issaquah, WA
National Provider Identifier
1043602899
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60945089 Issued in WA
Practice address
751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone
(425) 313-4000
NPI assigned
Mar 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 5101021512 MI
Emergency Medicine Physician 207P00000X 60945089 WA Primary
Emergency Medicine Physician 207P00000X 02006271A IN

Addresses

Primary practice location

751 NE Blakely Dr
Issaquah, WA 98029-6201

Mailing address

751 NE Blakely Dr
Issaquah, WA 98029-6201

Other practice location 1

PO Box 635004
Cincinnati, OH 45263-5004
Phone (888) 952-6772

Other practice location 2

702 Van Buren St
Fort Wayne, IN 46802-3697
Phone (856) 686-4341

Other identifiers 1

IdentifierTypeStateIssuer
0040883MedicaidOH

Other names 1

  • Dr. Morgan Mackenzie Wise Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210217001860 IN Practitioner - Emergency Medicine 1759681018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Practice addresses (Care Compare)

1701 S Creasy LN
Franciscan Health Lafayette East
Lafayette, IN 47905-4972
Phone (765) 502-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02006271AINMDEmergency Medicine Physician
60945089WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Jan 23, 2024 Accepting new patients

Locations

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

3929 E State Blvd
Fort Wayne, IN 46805
Phone (260) 435-7001

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

Organizations & group practices 2

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 3

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": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1043602899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 635004",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452635004",
            "country_code": "US",
            "telephone_number": "888-952-6772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468023697",
            "country_code": "US",
            "telephone_number": "856-686-4341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MORGAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "5101021512",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "60945089",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02006271A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0040883",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORGAN",
            "last_name": "WISE",
            "middle_name": "MACKENZIE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.