Benjamin Wisner, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

48586 Issued in CO

Practice address

2315 E Harmony Rd
Ste 140
Fort Collins, CO 80528-8620

Phone

(970) 484-6700

Fax

(970) 484-5723

NPI assigned

Jan 26, 2007

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 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

Specialty

Urology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Barbara Cottage Hospital Hospital, Santa Barbara, CA, CCN 050396

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rockymountainlithotripterllc.benjaminwisner@133913.advancedmd-direct.com
• Direct secure messaging: bwisner760811@hisp.ehr.sutterhealth.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.

• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1154354504
  Medicare reassignment Care Compare group NPD
• Sansum Clinic

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1144648015
  NPD
• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1932121514
  NPD
• Sansum Clinic

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1649296807
  NPD (past)

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

• Santa Barbara Cottage Hospital

  • General Acute Care Hospital
  • Santa Barbara, CA
  • NPI 1477554152
  Care Compare affiliation

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1396891982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 E HARMONY RD",
            "address_2": "STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288620",
            "telephone_number": "970-484-6700",
            "fax_number": "970-484-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E HARMONY RD",
            "address_2": "STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288620",
            "telephone_number": "970-484-6700",
            "fax_number": "970-484-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNER",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "48586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02452049",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Rose Wischow
• Wisdom Ways Acupuncture
• Larissa Wise
• Ella Rayne Wisely
• Katlynn Wiseman, BA
• Lailina S Wisoff, RD
• Ella Witcher
• Sarah Witschey
• Claire Witt, LPC
• Kelvin Daves Witt, D.C.

• Urology Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Urology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.