Matthew Jay Wise, M.D.

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

C55031 Issued in CA

Practice address

431 S Batavia St Ste 101
Orange, CA 92868-3937

Phone

(714) 363-3300

Fax

(714) 363-3847

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Obstetrics/Gynecology

Education

University of Virginia School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Vein Center, Inc.Group PAC ID 9335220201, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Advanced Vein Center, Inc.

  dba Advanced Vein Center

  • Preferred Provider Organization
  • Orange, CA
  • NPI 1659554095
  Medicare reassignment Care Compare group NPD
• Northern Inyo Associates

  • Clinic/Center
  • Bishop, CA
  • NPI 1649664848
  NPD (past)
• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  NPD (past)
• DHHS, PHS, Naihs, Gallup Indian Medical Center

  • Ambulatory Surgical Clinic/Center
  • Gallup, NM
  • NPI 1184890899
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1235107038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S BATAVIA ST STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683937",
            "telephone_number": "714-363-3300",
            "fax_number": "714-363-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S BATAVIA ST STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683937",
            "telephone_number": "714-363-3300",
            "fax_number": "714-363-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "MATTHEW",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CA",
            "license": "C55031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69422834",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista Winters
• Phillip Joseph Winters
• Wise Healthcare Services Inc.
• Agatha Ann Wise
• Gloria Alicia Wise
• Patrick Wise
• Jeanne Wojslaw
• Diane Sue Wolf, M.A.CCC
• Gregory H. Wolf, M.D.
• Ian Lawrence Wolf

• Phlebology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Phlebology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.