Victoria Wisnieski, PA
Individual provider Active NPI Physician Assistant · Perry, OH
NPI 1861233751 · NPPES record last updated Sep 5, 2025
Key facts
- NPI
- 1861233751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10445 (AZ)
- Practice address
- 4314 Mill Pond Cir
Perry, OH 44081-9545 - Phone
- (440) 413-9828
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mayo Clinic Arizona
Practice addresses (Care Compare)
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000
5701 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-4200
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
5779 E Mayo Blvd
Speciality Building
Phoenix, AZ 85054-4502
Phone (480) 301-8000
Hospital & facility affiliations
- Mayo Clinic Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240924003319 | AZ | Practitioner - Physician Assistant | 8022559509 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10445 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Arizona | Current |
Accepting new patients | |
| Mayo Clinic Arizona | Current |
Accepting new patients | |
| WD Recovery and Wellness Center, LLC | Past | Accepting new patients |
Locations
13400 E Shea Blvd
Scottsdale, AZ 85259
Interoperability endpoints
- victoria.wisnieski.1@1576.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10445 | AZ | Yes |
Addresses
Primary practice location
4314 Mill Pond Cir
Perry, OH 44081-9545
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Phone (480) 301-8000
Other practice location 1
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vwisnieski2549482@ehrdirect.mayoclinicmsg.org |
Other providers in Perry, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.