Individual provider Active NPI

Alyssa Renee Wiebel, PA

  • Surgical Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1750002598
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9116641 Issued in FL
Practice address
14601 Hope Center Loop
Fort Myers, FL 33912-4707
Phone
(239) 334-7000
Fax
(239) 334-7070
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9116641 FL Primary

Addresses

Primary practice location

14601 Hope Center Loop
Fort Myers, FL 33912-4707

Mailing address

14601 Hope Center Loop
Fort Myers, FL 33912-4707
Phone (239) 334-7000

Other identifiers 1

IdentifierTypeStateIssuer
PA9116641OtherFLMEDICAL LICENSE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221024002755 FL Practitioner - Physician Assistant 0840666368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Specialists of SW Florida, P.a.Group PAC ID 2668442799, 47 clinicians

Practice addresses (Care Compare)

14601 Hope Ctr Loop
Fort Myers, FL 33912-4707
Phone (239) 334-7000

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Merit-based Incentive Payment System (MIPS)

Final score
93.2 of 100Reported as group
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9116641FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of SW Florida, P.a. PastSince Sep 24, 2023 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.

Hospital & facility affiliations 2

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1750002598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 HOPE CENTER LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124707",
            "telephone_number": "239-334-7000",
            "fax_number": "239-334-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 HOPE CENTER LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124707",
            "telephone_number": "239-334-7000",
            "fax_number": "239-334-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBEL",
        "first_name": "ALYSSA",
        "middle_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9116641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9116641",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.