Individual provider Active NPI

Sandy Gay Wiese, CRNP

  • Acute Care Nurse Practitioner
  • Olney, MD
National Provider Identifier
1407477383
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R205784 Issued in MD
Practice address
18101 Prince Philip Dr
Olney, MD 20832-1514
Phone
(301) 774-8887
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R205784 MD Primary

Addresses

Primary practice location

18101 Prince Philip Dr
Olney, MD 20832-1514

Mailing address

18109 Prince Philip Dr
Olney, MD 20832-1519
Phone (301) 774-8962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201022000058 DC Practitioner - Nurse Practitioner 3870913338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

18101 Prince Philip Dr
Olney, MD 20832-1514
Phone (301) 570-7404

18105 Prince Philip Dr
Olney, MD 20832-1514
Phone (301) 774-8962

18111 Prince Philip Dr
Olney, MD 20832-1513
Phone (301) 774-7170

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

Hospital & facility affiliations

  • Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R205784MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 9, 2020 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

Organizations & group practices 1

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 1

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": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1407477383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18109 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321519",
            "telephone_number": "301-774-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321514",
            "telephone_number": "301-774-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "SANDY",
        "middle_name": "GAY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R205784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.