Individual provider Active NPI

John Samuel Wiener, MD

  • Urology Physician
  • Durham, NC
National Provider Identifier
1407892748
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
33913 Issued in NC
Practice address
Erwin Road
Durham, NC 27710-2121
Phone
(919) 684-6994
Fax
(919) 681-5507
NPI assigned
Jun 22, 2006
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 33913 NC Primary

Addresses

Primary practice location

Erwin Road
Durham, NC 27710-2121

Mailing address

Box 3831 Duke University Medical Center
Durham, NC 27710-2121
Phone (919) 684-6994

Other identifiers 1

IdentifierTypeStateIssuer
891047FMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100107000545 NC Practitioner - Urology 1850386822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Tulane University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

2351 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33913NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
University Surgery Associates, PLLC Urology Past Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

234 Crooked Creek Pkwy
Durham, NC 27713
Phone (919) 385-3000

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3480 Wake Forest Rd
Ste 502
Raleigh, NC 27609
Phone (919) 420-5000

Interoperability endpoints

  • Direct secure messaging: jwiener5661@direct.medicine.duke.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1407892748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 3831 DUKE UNIVERSITY MEDICAL CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277102121",
            "telephone_number": "919-684-6994",
            "fax_number": "919-681-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277102121",
            "telephone_number": "919-684-6994",
            "fax_number": "919-681-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "JOHN",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "33913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891047F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.