Individual provider Active NPI

Joseph Wisterman

  • Anesthesiologist Assistant
  • Springfield, MO
National Provider Identifier
1790173474
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-6000
NPI assigned
Jan 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

1000 E Primrose St Ste 520
Springfield, MO 65807-5180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150115001481 MO Practitioner - Anesthesiology Assistant 8224352570 Reassigns benefits to 1 organization
I20181129003063 FL Practitioner - Anesthesiology Assistant 8224352570 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Feinerman Anesthesia PA CurrentSince Jan 1, 2023 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 1, 2022 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 1, 2022 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiologist Assistant CurrentSince Dec 11, 2023 Accepting new patients
Vitalmd Group Holding LLC Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

402 Jeffords St
Clearwater, FL 33756
Phone (423) 505-2653

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8500 SW 92nd St
Ste 204
Miami, FL 33156
Phone (305) 270-8944

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

5245 E Fletcher Ave
Ste 1
Temple Terrace, FL 33617
Phone (813) 676-8851

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

NPI Registry JSON

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1790173474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST STE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISTERMAN",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.