Active NPI
James Eric Wiedeman, M.D.
- Surgery Physician
- Mather, CA
National Provider Identifier
1780667345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G77763
- Practice address
- 10535 Hospital Way
Mather, CA 95655-4200 - Phone
- (916) 843-7222
- Fax
- (916) 366-5475
- NPI assigned
- Nov 28, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G77763 | CA | Primary |
Addresses
Primary practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
419 Heron PL
Davis, CA 95616-7512
Phone (530) 759-0726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141203000535 | CA | Order and Referring Only - General Surgery | 3779771993 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77763 | CA | MD | Social Worker |
| G77763 | CA | MD | Surgery Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1780667345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 HERON PL",
"city": "DAVIS",
"state": "CA",
"postal_code": "956167512",
"telephone_number": "530-759-0726",
"fax_number": "916-366-5482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-7222",
"fax_number": "916-366-5475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDEMAN",
"first_name": "JAMES",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G77763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.