NPIMap

Individual provider Active NPI

Benjamin Robert Wiele, M.D.

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1164777694
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2012020894 Issued in MO
Practice address
625 S New Ballas Rd Ste 2015
Saint Louis, MO 63141
Phone
(314) 251-1700
NPI assigned
Jul 20, 2012
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2012020894 MO Primary

Addresses

Primary practice location

625 S New Ballas Rd Ste 2015
Saint Louis, MO 63141

Mailing address

625 S New Ballas Rd Ste 2015
Saint Louis, MO 63141-8253
Phone (314) 251-1700

Other practice location 1

1000 E Cherry St Fl 3
Troy, MO 63379-1513
Phone (314) 251-1700

Other identifiers 1

IdentifierTypeStateIssuer
2012020894OtherMOMO STATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180801000688 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2860621182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

625 S New Ballas Rd
Suite 2015
Saint Louis, MO 63141-8253
Phone (314) 251-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012020894MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bwiele988734@directc.mercy.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1164777694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD STE 2015",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD STE 2015",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Cherry St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633791513",
            "country_code": "US",
            "telephone_number": "314-251-1700",
            "fax_number": "314-251-1701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIELE",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2012020894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO STATE MEDICAL LICENSE",
            "identifier": "2012020894",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.