Individual provider Active NPI

Cherese Marie Wiley, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1154527513
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N4202 Issued in TX
Practice address
3417 Gaston Ave Ste 700
Dallas, TX 75246-2031
Phone
(214) 823-4800
Fax
(214) 823-4801
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 N4202 TX Primary

Addresses

Primary practice location

3417 Gaston Ave Ste 700
Dallas, TX 75246-2031

Mailing address

3417 Gaston Ave Ste 700
Dallas, TX 75246-2031
Phone (214) 823-4800

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
I20091211000438 TX Practitioner - Internal Medicine 1355481953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Meharry Medical College School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abksw Preferred Health Partners, PLLCGroup PAC ID 2961710892, 48 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Suite 700
Dallas, TX 75246-2031
Phone (241) 823-4800

440 W
635 Suite 405
Irving, TX 75063
Phone (972) 993-5080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N4202TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Oct 15, 2018 Accepting new patients
Abksw Preferred Health Partners, PLLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 15, 2018 Accepting new patients
Digestive Health Associates of Texas, P.a. Past Accepting new patients

Locations

3417 Gaston Ave
Ste 700
Dallas, TX 75246
Phone (214) 823-4800

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

440 W Lyndon B Johnson Fwy
Ste 405
Irving, TX 75063
Phone (214) 823-4800

Interoperability endpoints

  • Direct secure messaging: cherese.wiley@ntphp.eclinicaldirectplus.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1154527513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462031",
            "telephone_number": "214-823-4800",
            "fax_number": "214-823-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462031",
            "telephone_number": "214-823-4800",
            "fax_number": "214-823-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "CHERESE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N4202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.