Individual provider Active NPI

Frederick Wiseman, DPM

  • Foot & Ankle Surgery Podiatrist
  • Sturgis, MI
National Provider Identifier
1972506558
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901000866 Issued in MI
Practice address
102 S Lakeview Ave
Sturgis, MI 49091-1947
Phone
(269) 651-2320
Fax
(269) 659-4704
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901000866 MI Primary

Addresses

Primary practice location

102 S Lakeview Ave
Sturgis, MI 49091-1947

Mailing address

PO Box 730
Sturgis, MI 49091-0730
Phone (269) 651-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221031000480 AL Practitioner - Podiatry 4385627793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360Care Services of Al LLCGroup PAC ID 7719240977, 29 clinicians

Practice addresses (Care Compare)

150 S Perry St
Montgomery, AL 36104-4227
Phone (248) 528-2116

Merit-based Incentive Payment System (MIPS)

Final score
75.77 of 100Reported as group
Quality
45.94
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue2053
Removal or shaving of skin growth48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360Care Services of Al LLC CurrentSince Oct 13, 2022 Accepting new patients
Onsight, Inc. Past Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
Dpmwoleryproh LLC Past Accepting new patients
Rochester Center for Foot and Ankle Surgery PLLC Past Accepting new patients
Dpmgiaimoproh LLC Foot & Ankle Surgery Past Accepting new patients
Trevor Neal DPM Past Accepting new patients

Locations

150 S Perry St
Montgomery, AL 36104
Phone (225) 270-1012

523 Gandy St NE
Ste A
Russellville, AL 35653
Phone (205) 208-9955

11 Bell Rd
Selma, AL 36701
Phone (334) 874-7425

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

Interoperability endpoints

  • Direct secure messaging: frederick.wiseman.1@4399.direct.athenahealth.com

Organizations & group practices 7

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1972506558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490910730",
            "telephone_number": "269-651-2320",
            "fax_number": "269-659-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S LAKEVIEW AVE",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490911947",
            "telephone_number": "269-651-2320",
            "fax_number": "269-659-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "FREDERICK",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgis, MI

Sources for this page

Verify at the official NPI Registry.