NPIMap

Individual provider Active NPI

Jessica Kathryn Wise, MD

  • Surgery Physician
  • Evansville, IN
National Provider Identifier
1487117123
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01098342A Issued in IN
Practice address
520 Mary St Ste 520
Evansville, IN 47710-1682
Phone
(812) 424-8231
Fax
(812) 435-8794
NPI assigned
Apr 10, 2019
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01098342A IN Primary

Addresses

Primary practice location

520 Mary St Ste 520
Evansville, IN 47710-1682

Mailing address

520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Other practice location 1

4133 Gateway Blvd Ste 290
Newburgh, IN 47630-7918
Phone (812) 424-8231

Other practice location 2

801 Saint Marys Dr Ste 200E
Evansville, IN 47714-0518
Phone (812) 424-8231

Other identifiers 5

IdentifierTypeStateIssuer
1105908069OtherINBCBS
076217OtherPACERTIFICATION
300124433MedicaidIN
01098342OtherINLICENSE
7101114240MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250611001618 NY Practitioner - General Surgery 9335659093
I20251124003437 IN Practitioner - General Surgery 9335659093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Missouri, Kansas City, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evansville Surgical Associates IncGroup PAC ID 1557346723, 45 clinicians

Practice addresses (Care Compare)

801 Saint Marys Dr
Suite 200E
Evansville, IN 47714-0518
Phone (812) 424-8231

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01098342AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Evansville Surgical Associates Inc Surgery CurrentSince Jan 1, 2026 Accepting new patients
St Mary's Medical Group, LLC PastSince Jan 1, 2026 Accepting new patients
New York Robotic and Laparoscopic Surgery PC Surgery Past Accepting new patients

Locations

520 Mary St
Ste 520
Evansville, IN 47710
Phone 8124248231267

801 Saint Marys Dr
Ste 200E
Evansville, IN 47714
Phone 8124248231 ext. 2220

4133 Gateway Blvd
Ste 290
Newburgh, IN 47630
Phone (812) 842-2701

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71249
  • Direct secure messaging: jwise141534@direct.luhs.org

Organizations & group practices 4

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 9

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1487117123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4133 Gateway Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307918",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Saint Marys Dr Ste 200E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140518",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "JESSICA",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2026-09-29",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01098342A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1105908069",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "076217",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300124433",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "01098342",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101114240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.