Brenda S. Wiley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002581A Issued in IN

Practice address

7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128

Phone

(260) 432-2297

Fax

(260) 969-7266

NPI assigned

Feb 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Eon Care Clinicians PCGroup PAC ID 1052833951, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
• St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brenda.wiley@lutheranhealthnetwork.cernerdirect.com

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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805
  Medicare reassignment Care Compare group NPD
• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490

  IN

  Medicare reassignment Care Compare group
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adams County Memorial Hospital

  • Critical Access Hospital
  • Decatur, IN
  • NPI 1689696148
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation
• St. Joseph Health System, LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1023060472
  Care Compare affiliation

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1801064266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-432-2297",
            "fax_number": "260-969-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "BRENDA",
        "middle_name": "S.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002581A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3040613",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200888290",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brenda.wiley@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7900 W Jefferson Blvd",
            "address_2": "Suite 201",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Esther E Wilcox, MSED, LMFT
• Kristen Wilcox
• Matthew Zachary Wilcox
• Rose Carolyn Wilcox, A.C.N.P.
• Wildflower Counseling
• Quinn Wiley, MPM, ATC, LAT
• Mary Ruth Wilger, DO
• Beth Woodward Wilges, LCSW
• April Wilk, OTR/L
• Josiah Arthur Wilkie, DPT

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.
• 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.