Individual provider Active NPI

Carissa Wieseler, MD

  • Diagnostic Radiology Physician
  • Omaha, NE
National Provider Identifier
1881183747
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36221 Issued in NE
Practice address
14441 Dupont CT Ste 304
Omaha, NE 68144-2107
Phone
(402) 597-8775
NPI assigned
May 7, 2018
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 73126 MN
Diagnostic Radiology Physician 2085R0202X TRN28156 FL
Diagnostic Radiology Physician 2085R0202X 36221 NE Primary

Addresses

Primary practice location

14441 Dupont CT Ste 304
Omaha, NE 68144-2107

Mailing address

14441 Dupont CT Ste 304
Omaha, NE 68144-2107
Phone (402) 597-8775

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 2

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-0411

Other practice location 3

225 Front St
Binghamton, NY 13905-2474
Phone (607) 772-3530

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwieseler1950326@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240805003104 NE Practitioner - Diagnostic Radiology 7315303526 Reassigns benefits to 1 organization
I20240930000252 IA Practitioner - Diagnostic Radiology 7315303526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Consultants PCGroup PAC ID 8325947799, 45 clinicians

Practice addresses (Care Compare)

14040 Boys Town Hospital Rd
Boys Town, NE 68010-7521
Phone (402) 484-6677

603 Rosary Dr
Corning, IA 50841-1683
Phone (641) 322-6278

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN28156FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Consultants PC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients

Locations

603 Rosary Dr
Corning, IA 50841
Phone (641) 322-3121

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

14040 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6800

14441 DuPont Ct
Ste 304
Omaha, NE 68144
Phone (402) 597-8775

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

Interoperability endpoints

  • Direct secure messaging: cwieseler424568@direct.shands.ufl.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1881183747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14441 DUPONT CT STE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442107",
            "telephone_number": "402-597-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14441 DUPONT CT STE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442107",
            "telephone_number": "402-597-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-0411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Front St",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139052474",
            "country_code": "US",
            "telephone_number": "607-772-3530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESELER",
        "first_name": "CARISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "73126",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "TRN28156",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "36221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwieseler1950326@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.