Adam Wise, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125080835 Issued in IL

Practice address

3249 Oak Park Ave
Berwyn, IL 60402-3429

Phone

(740) 438-8789

NPI assigned

Mar 23, 2022

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

Medicare fee-for-service enrollment

Enrolled in WI

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

Internal Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Midwest Orthopedic Specialty Hospital Hospital, Franklin, WI, CCN 520205
• Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awise40022@direct.luhs.org

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482

  Family Medicine

  Medicare reassignment NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD
• Columbia St. Mary'S Hospital Milwaukee Inc

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Mequon, WI
  • NPI 1710928221

  Family Medicine

  NPD (past)

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

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension St Francis Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1225087190
  Care Compare affiliation
• Midwest Orthopedic Specialty Hospital, LLC

  • Special Hospital
  • Franklin, WI
  • NPI 1861635971
  Care Compare affiliation

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1356090534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 WASHINGTON BLVD APT 1I",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024165",
            "telephone_number": "740-438-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "740-438-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125080835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.