Individual provider Active NPI

Ciara Lauren Wisecup, MD

  • Pulmonary Disease Physician
  • Dallas, TX
National Provider Identifier
1861955544
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
U6833 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2088
Phone
(214) 820-2361
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X U6833 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2088

Mailing address

5761 Lawndale Dr Apt B
El Paso, TX 79912-4256
Phone (512) 213-5489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250820003000 TX Practitioner - Pulmonary Disease 5092040428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

3600 Gaston Ave
Suite 656
Dallas, TX 75246-1906
Phone (214) 820-3466

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 22, 2025 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Sep 22, 2025 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

3410 Worth St
Ste 250
Dallas, TX 75246
Phone (214) 820-6856

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

Interoperability endpoints

  • Direct secure messaging: cwisecup483489@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1861955544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 LAWNDALE DR APT B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799124256",
            "telephone_number": "512-213-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462088",
            "telephone_number": "214-820-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISECUP",
        "first_name": "CIARA",
        "middle_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "U6833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.