Jason C Wieseler, PSY.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY7276 Issued in FL

Practice address

400 E Sheridan Rd
Melbourne, FL 32901-3122

Phone

(321) 722-5200

NPI assigned

Jun 26, 2006

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Space Coast Health Centers IncGroup PAC ID 8224445531, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17832/brand/2/csg/41/fhir/r4

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.

• Space Coast Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Titusville, FL
  • NPI 1144819319
  Medicare reassignment Care Compare group NPD
• Indialantic Psychiatry & Counseling Center, Inc.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Indialantic, FL
  • NPI 1770528846
  NPD (past)

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

• North Brevard County Hospital District

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1528095544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013122",
            "telephone_number": "321-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013122",
            "telephone_number": "321-722-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESELER",
        "first_name": "JASON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY7276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076722100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wickham Pediatrics Center PS
• Kristen Jane Wiederhold
• Alexandrea Hope Wiegand, M.S., BCBA
• Gabrielle Wienckoski, APRN
• Adam Howard Wiener, D.O.
• Phylicia Wiggins-Hutchinson
• Ann Susan Wilbee, LCSW
• Melissa Wilborn, LMHC
• Yvette Marie Devine Wild
• David Wilder, PH.D.

• Counseling Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.