Individual provider Active NPI

Michael Brent Wiens, MD

  • Surgery Physician
  • Shawnee, OK
National Provider Identifier
1750321857
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
19657 Issued in OK
Practice address
3315 Kethley Rd
Shawnee, OK 74804-9638
Phone
(405) 273-5801
Fax
(405) 878-3794
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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 19657 OK Primary

Addresses

Primary practice location

3315 Kethley Rd
Shawnee, OK 74804-9638

Mailing address

PO Box 258884
Oklahoma City, OK 73125-8884
Phone (405) 231-3857

Other identifiers 1

IdentifierTypeStateIssuer
100193970AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091228000186 OK Practitioner - General Surgery 3870680028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

2401 W Wrangler Blvd
Seminole, OK 74868-1917
Phone (405) 382-3650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
81.18
Promoting interoperability
93
Improvement activities
40
Cost
72.93

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Upper gastrointestinal (GI) endoscopy for acid reflux83
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19657OKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc. CurrentSince May 1, 2012 Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince May 1, 2012 Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Saints Medical Group, LLC CurrentSince Oct 12, 2022 Accepting new patients
Saints Medical Group, LLC CurrentSince Oct 12, 2022 Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

2401 W Wrangler Blvd
Seminole, OK 74868
Phone (405) 303-4000

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Interoperability endpoints

  • Direct secure messaging: mwiens165654@direct-ehr-ssmhc.com

Organizations & group practices 6

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1750321857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258884",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731258884",
            "telephone_number": "405-231-3857",
            "fax_number": "405-272-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENS",
        "first_name": "MICHAEL",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "19657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100193970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.