Individual provider Active NPI

Kristen Nichole Wisler, M.D.

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1134514235
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME136776 Issued in FL
Practice address
86 W Underwood St
Orlando, FL 32806-1110
Phone
(888) 912-3648
Fax
(321) 841-4085
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME136776 FL Primary

Addresses

Primary practice location

86 W Underwood St
Orlando, FL 32806-1110

Mailing address

3090 Caruso CT Ste 50
Orlando, FL 32806-8510
Phone (407) 481-7179

Other practice location 1

21 Columbia St Ste 102
Orlando, FL 32806-1133
Phone (407) 841-5145

Other identifiers 1

IdentifierTypeStateIssuer
025184200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180727002733 FL Practitioner - Internal Medicine 3072827518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2018 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

21 Columbia St
Ste 102
Orlando, FL 32806
Phone (407) 841-5145

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kwisler25956@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1134514235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 CARUSO CT STE 50",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068510",
            "telephone_number": "407-481-7179",
            "fax_number": "407-481-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Columbia St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061133",
            "country_code": "US",
            "telephone_number": "407-841-5145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISLER",
        "first_name": "KRISTEN",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME136776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025184200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.