Mark A Wyse, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12165 Issued in AZ

Practice address

4600 E Shea Blvd Ste 100
Phoenix, AZ 85028-6031

Phone

(602) 955-8700

Fax

(602) 553-8142

NPI assigned

Mar 25, 2006

Sex

Male

Sole proprietor

No

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 AZ

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

Family Practice

Education

University of Kentucky College of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Wellness ResourcesGroup PAC ID 6002296506, 37 clinicians

Family Practice Specialists LTD.Group PAC ID 6608851688, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assisteo Home Health Home health agency, Phoenix, AZ, CCN 037262
• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.wyse.1@1482.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1482/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/27041/brand/1/csg/1/fhir/r4

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.

• Family Practice Specialists LTD.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1972563187
  Medicare reassignment Care Compare group NPD Authorized official
• Access Wellness Resources

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1568116291

  AZ

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Azhomehealth LLC

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1568639557
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1346200060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E SHEA BLVD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286031",
            "telephone_number": "602-955-8700",
            "fax_number": "602-553-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E SHEA BLVD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286031",
            "telephone_number": "602-955-8700",
            "fax_number": "602-553-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSE",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2024-03-29",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "12165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "12165",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Wyma, PA-C
• Jacqueline Marie Wyman, MS, RD, LD
• Joy Lynn Wynkoop, LAC
• Joel Wyse, OD
• Kristin Wyse, MA, LPC
• Sienna L Wyse
• Barbara Wysocki, FNP-C
• Stanley Wysocki
• Joelle Wysoski, CPNP
• Taylor Wyss

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.