Active NPI
Benjamin Ernest Wiseman, MD
- Pain Medicine (Anesthesiology) Physician
- Tupelo, MS
National Provider Identifier
1649289794
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jan 19, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 18380
- Practice address
- 830 S Gloster St
Tupelo, MS 38801 - Phone
- (662) 377-4394
- Fax
- (662) 377-7045
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 18380 | MS | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 18380 | MS | Primary |
Addresses
Primary practice location
830 S Gloster St
Tupelo, MS 38801
Mailing address
PO Box 3294
Tupelo, MS 38803
Phone (662) 377-4394
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00681735 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tupelo Anesthesia Group PA | Anesthesiology | Past | Accepting new patients |
| North Mississippi Pain Management Center | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Tupelo, MS
- NPI 1134320831
-
- Anesthesiology Physician
- Tupelo, MS
- NPI 1558390443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1649289794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3294",
"city": "TUPELO",
"state": "MS",
"postal_code": "38803",
"telephone_number": "662-377-4394",
"fax_number": "662-377-7045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S GLOSTER ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "38801",
"telephone_number": "662-377-4394",
"fax_number": "662-377-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISEMAN",
"first_name": "BENJAMIN",
"middle_name": "ERNEST",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MS",
"license": "18380",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MS",
"license": "18380",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00681735",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.