Individual provider Active NPI

John Wisener, MD

  • Internal Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1275111957
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101281282 Issued in VA
Practice address
500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone
(434) 654-7000
NPI assigned
Apr 1, 2021
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X VA
Internal Medicine Physician 207R00000X 0101281282 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668

Mailing address

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-0000

Other practice location 1

1215 Lee St.,
Mail Stop 800744
Charlottesville, VA 22908-0816
Phone (434) 924-1931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240930003211 VA Practitioner - Internal Medicine 0547661696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15225 Heathcote Blvd
Haymarket, VA 20169-6264
Phone (240) 686-2300

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-7147

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 369-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101281282VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Jul 23, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Jul 23, 2024 Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Interoperability endpoints

  • Direct secure messaging: john.wisener.1@20955.direct.athenahealth.com

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 3

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1275111957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St.,",
            "address_2": "Mail Stop 800744",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-1931",
            "fax_number": "434-243-5770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISENER",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101281282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.