NPIMap

Individual provider Active NPI

Robert David Wissman, M.D.

  • Diagnostic Radiology Physician
  • Columbia, MO
National Provider Identifier
1760412167
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2019033514 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 882-2663
Fax
(573) 884-4608
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35-08-3106 OH
Diagnostic Radiology Physician 2085R0202X 2019033514 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65212-0001

Mailing address

5400 Kennedy Ave
Cincinnati, OH 45213-2664
Phone (513) 281-3400

Other practice location 1

5400 Kennedy Ave
Cincinnati, OH 45213-2664
Phone (513) 281-3400

Other identifiers 1

IdentifierTypeStateIssuer
2426726MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190930001314 MO Practitioner - Diagnostic Radiology 2062317753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019033514MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Sep 16, 2019 Accepting new patients
The Curators of the University of Missouri CurrentSince Sep 16, 2019 Accepting new patients
Jackson Madison County General Hospital Past Accepting new patients
Riverhills Healthcare Inc Diagnostic Radiology PastSince Jan 1, 2016 Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Riverhills Healthcare, Inc. Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients

Locations

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

3 Hospital Dr
Columbia, MO 65201
Phone (573) 882-8913

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.822

Organizations & group practices 7

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 9

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1760412167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 KENNEDY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452132664",
            "telephone_number": "513-281-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-2663",
            "fax_number": "573-884-4608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Kennedy Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452132664",
            "country_code": "US",
            "telephone_number": "513-281-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISSMAN",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35-08-3106",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019033514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2426726",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652015276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.