NPIMap

Individual provider Active NPI

Edward A Wiese, MD

  • Internal Medicine Physician
  • Ashtabula, OH
National Provider Identifier
1235196866
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35069100 Issued in OH
Practice address
2422 Lake Ave
Ashtabula, OH 44004-4985
Phone
(440) 992-4422
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 35069100 OH Primary

Addresses

Primary practice location

2422 Lake Ave
Ashtabula, OH 44004-4985

Mailing address

2422 Lake Ave
Ashtabula, OH 44004-4985
Phone (440) 992-4422

Other identifiers 1

IdentifierTypeStateIssuer
0386014MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20191024001650 CO Practitioner - Internal Medicine 0941345219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspen Valley Hospital Clinics, PLLCGroup PAC ID 3375891013, 23 clinicians

Practice addresses (Care Compare)

401 Castle Creek Rd
Aspen, CO 81611-1159
Phone (970) 544-1120

Hospital & facility affiliations

  • Aspen Valley Hospital District Hospital, Aspen, CO, CCN 061324
  • Valley View Hospital Association Hospital, Glenwood Springs, CO, CCN 060075

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Aspen Valley Hospital Clinics, PLLC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Aspen Valley Hospital District Clinics CurrentSince Oct 1, 2019 Accepting new patients
Aspen Valley Hospital District CurrentSince Oct 1, 2019 Accepting new patients
Aspen Valley Hospital District CurrentSince Oct 1, 2019 Accepting new patients
Ashtabula County Medical Center PastSince Jan 19, 2025 Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

401 Castle Creek Rd
Ofc
Aspen, CO 81611
Phone (970) 544-1128

1460 E Valley Rd
Ste 103
Basalt, CO 81621
Phone (970) 279-4111

Interoperability endpoints

  • Direct secure messaging: ewiese164513@direct.ccf.org
  • FHIR API: https://epicproxy.et1254.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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 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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1235196866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-992-4422",
            "fax_number": "440-997-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-992-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35069100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0386014",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.