NPIMap

Individual provider Active NPI

Tanya A Wiese, D.O.

  • Pulmonary Disease Physician
  • Louisville, KY
National Provider Identifier
1992737886
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
02781 Issued in KY
Practice address
4950 Norton Healthcare Blvd Ste 208
Louisville, KY 40241-2847
Phone
(502) 614-4179
Fax
(502) 614-4450
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 02002644A IN
Pulmonary Disease Physician 207RP1001X 02781 KY Primary

Addresses

Primary practice location

4950 Norton Healthcare Blvd Ste 208
Louisville, KY 40241-2847

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

3430 Newburg Rd Ste 150
Louisville, KY 40218-2497
Phone (502) 459-9127

Other identifiers 3

IdentifierTypeStateIssuer
000000290297OtherKYANTHEM
200456800MedicaidIN
64066590MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/
Direct Messaging Address twiese53762@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000577 KY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7416091228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Michigan State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02002644AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Pulmonary Disease CurrentSince Oct 1, 2018 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

207 Sparks Ave
Ste 402
Jeffersonvlle, IN 47130
Phone (812) 283-7818

3430 Newburg Rd
Ste 150
Louisville, KY 40218
Phone (502) 459-9127

850 S 28th St
Ste 104
Louisville, KY 40211
Phone (502) 394-5678

4950 Norton Healthcare Blvd
Ste 208
Louisville, KY 40241
Phone (502) 559-5864

676 S Floyd St
Ste 200
Louisville, KY 40202
Phone (502) 629-2500

4606 Greenwood Rd
Louisville, KY 40258
Phone (502) 937-2209

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: twiese53762@direct.nortonhealthcare.org

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1992737886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 NORTON HEALTHCARE BLVD STE 208",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412847",
            "telephone_number": "502-614-4179",
            "fax_number": "502-614-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3430 Newburg Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402182497",
            "country_code": "US",
            "telephone_number": "502-459-9127",
            "fax_number": "502-459-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESE",
        "first_name": "TANYA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "02002644A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "02781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000290297",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200456800",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64066590",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4950 Norton Healthcare Blvd Ste 208",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402412847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twiese53762@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "4950 Norton Healthcare Blvd Ste 208",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402412847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.