Jeffrey Bruce Wise, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

239180 Issued in NY

Practice address

1680 Route 23 Ste 120
Wayne, NJ 07470-7520

Phone

(973) 305-1400

NPI assigned

May 15, 2007

Last updated

Jul 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jwise684465@nychhc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey B. Wise, M.D., L.L.C.

  • Medical Specialty Clinic/Center
  • Wayne, NJ
  • NPI 1124216718
  Medicare reassignment Authorized official
• Select Anesthesia and Pain Management Group, PA

  • Anesthesiology Physician
  • Pompton Plains, NJ
  • NPI 1528043692
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1760698716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23 STE 120",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707520",
            "telephone_number": "973-305-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23 STE 120",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707520",
            "telephone_number": "973-305-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JEFFREY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "239180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willowbrook Pediatrics
• Mini Willphine, MSN,APN,AGACNP-BC,CC
• Courtney Wilson
• Renee Elizabeth Wilson, PH.D.
• Abigail R Windisch, AUD
• Mordecai M. Witkin, D.P.M.
• Heather Wolak
• James L Wolf, DC
• Women Pelvic Surgery of North Jersey LLC
• Daniel S Wong, DPT

• Facial Plastic Surgery Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Facial Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.