Individual provider Active NPI

Alphaeus Mansfield Wise, M.D.

  • Family Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1265475628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A95309 Issued in CA
Practice address
1150 Civic Dr
Suite100
Walnut Creek, CA 94596-8241
Phone
(925) 935-3113
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A95309 CA Primary

Addresses

Primary practice location

1150 Civic Dr
Suite100
Walnut Creek, CA 94596-8241

Mailing address

1150 Civic Dr
Suite100
Walnut Creek, CA 94596-8241

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061006000585 CA Practitioner - Family Practice 7517918808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1181 Boulevard Way
Suite B
Walnut Creek, CA 94595-1186
Phone (925) 935-3113

Hospital & facility affiliations

  • John Muir Home Health Services Home health agency, Concord, CA, CCN 057276
  • American Home Health Care, LLC Home health agency, Dublin, CA, CCN 059145
  • Health Link Home Health Agency Home health agency, San Francisco, CA, CCN 059016
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95309CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Medical, Inc. Family Medicine CurrentSince May 12, 2006 Accepting new patients
Julia S. Hohman, M.D., Inc. PastSince Feb 10, 2014 Accepting new patients

Locations

1181 Boulevard Way
Ste B
Walnut Creek, CA 94595
Phone (925) 934-7691

1150 Civic Dr
Ste 100
Walnut Creek, CA 94596
Phone (925) 935-3113

Interoperability endpoints

  • Direct secure messaging: awise48850@hpmg.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265475628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 CIVIC DR",
            "address_2": "SUITE100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CIVIC DR",
            "address_2": "SUITE100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968241",
            "telephone_number": "925-935-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ALPHAEUS",
        "middle_name": "MANSFIELD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A95309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.