Megan SK Wiese, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

29168 Issued in AZ

Practice address

2130 Mesquite Ave Unit 106
Lake Havasu City, AZ 86403-6897

Phone

(928) 854-6249

Fax

(928) 854-6301

NPI assigned

Aug 5, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 30, 2021 through Apr 30, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ndi9829@yourcarecommunity.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.

• Megan S K Wiese MD PC

  • Obstetrics & Gynecology Physician
  • Lake Havasu City, AZ
  • NPI 1033394002
  NPD
• Havasu Regional Medical Center LLC

  dba Havasu Regional Medical Center

  • Rural Acute Care Hospital
  • Lake Havasu City, AZ
  • NPI 1780761866
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1407865868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MESQUITE AVE UNIT 106",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036897",
            "telephone_number": "928-854-6249",
            "fax_number": "928-854-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MESQUITE AVE UNIT 106",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036897",
            "telephone_number": "928-854-6249",
            "fax_number": "928-854-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "MEGAN",
        "middle_name": "SK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "29168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0735830",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "577091",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Arizona Foot & Ankle
• Western Regional Neurology, LLC
• Matthew James Wetzel
• Kristy M Whelan, DO
• Thomas Stampfer White
• Joni Wiggins
• Ruth Ellen Wilcox, LMFT
• Floyd Wilks Jr., MD
• Jan Susan Williams, MS LPC
• Lisa Victoria Williams, PA

• Obstetrics & Gynecology Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.