Jeffrey Scott Wiseman, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

190990 Issued in NY

Practice address

30 Harrison St Ste 455
Johnson City, NY 13790-2176

Phone

(607) 763-8100

Fax

(607) 763-8048

NPI assigned

Dec 31, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Troy, PA
  • NPI 1376592493
  NPD (past)

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1235469974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-763-8100",
            "fax_number": "607-763-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST STE 455",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902176",
            "telephone_number": "607-763-8100",
            "fax_number": "607-763-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-31",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "190990",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "190990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01236451",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Williams, OTR-L
• Christopher Devon Williamson, PA-C
• Kelly Wilmarth, C-FNP
• Mark Vincent Wilson, MD
• Rhonda Marie Winner-Dodzweit, COTA
• Kathleen Joan Wold, ANP EDD
• Michael Wolff, MD
• Loren Wolsh, MD
• Women2Women Obstetrics and Gynecology, LLC
• Womens OBGYN PC

• Colon & Rectal Surgery Physician in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Colon & Rectal Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.