Joel Wise, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA12151 Issued in TX

Practice address

1325 Pennsylvania Ave Ste 680
Fort Worth, TX 76104

Phone

(817) 250-4235

Fax

(817) 885-7701

NPI assigned

Jun 4, 2018

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comanche County Medical Center CompanyGroup PAC ID 3678753357, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Comanche County Medical Center Hospital, Comanche, TX, CCN 451382

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Comanche County Medical Center Company

  • Critical Access Hospital
  • Comanche, TX
  • NPI 1346544616
  Medicare reassignment Care Compare group
• Comanche County Medical Center Company

  • Community/Retail Pharmacy
  • Rising Star, TX
  • NPI 1679174882
  NPD

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

• Comanche County Medical Center Company

  • Critical Access Hospital
  • Comanche, TX
  • NPI 1346544616
  Care Compare affiliation

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1548752744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 680",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042133",
            "telephone_number": "817-250-4235",
            "fax_number": "817-885-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 680",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-250-4235",
            "fax_number": "817-885-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JOEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA12151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Winter, FNP
• Tara Leigh Wisdom, PT
• David Andrew Wise, M.D.
• Deeana Wise
• Denise Kathleen Wise, M.D.
• Alyson Wiseman
• Cymone Wisemon
• Sheryl Sabillo Wiser, M.D.
• Wish Mema
• William R Witham, M.D.

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.