| Denise Kathleen Wise, MD | |
|
800 5th Ave, Suite 400, Fort Worth, TX 76104-7300 | |
| (817) 924-1999 | |
| (817) 886-0881 |
| Full Name | Denise Kathleen Wise |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 29 Years |
| Location | 800 5th Ave, Fort Worth, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184634586 | NPI | - | NPPES |
| 00A743940 | Medicaid | CA | |
| 104612003 | Medicaid | TX | |
| 104612005 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | A74394 (California) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | K3002 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| El Camino Hospital | Mountain view, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Silicon Valley Diagnostic Imaging Inc | 5496838518 | 70 |
| Entity Name | Silicon Valley Diagnostic Imaging Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629265806 PECOS PAC ID: 5496838518 Enrollment ID: O20080213000359 |
| Entity Name | Silicon Valley Medical Development Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164880761 PECOS PAC ID: 6103115183 Enrollment ID: O20160513001617 |
| Entity Name | Smi Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972004489 PECOS PAC ID: 3476696220 Enrollment ID: O20180825000009 |
| Entity Name | Health Diagnostics Of California A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104321959 PECOS PAC ID: 4284621525 Enrollment ID: O20180825000084 |
| Mailing Address | Practice Location Address |
|---|---|
| Denise Kathleen Wise, MD 800 5th Ave, Suite 400, Fort Worth, TX 76104-7300 Ph: (817) 924-1999 | Denise Kathleen Wise, MD 800 5th Ave, Suite 400, Fort Worth, TX 76104-7300 Ph: (817) 924-1999 |
Kelly C Starkey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 Fax: 469-522-6889 | |
Dr. Mark Sohner, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 173-210-4048 | |
Dr. John A Queralt, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033 | |
Dr. Robert Joseph Reeb Jr., MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033 | |
Eugenia Payne, M.D Radiology Medicare: Medicare Enrolled Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 | |
Dr. Jeffrey Scott Wenzel, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0387 | |
Dr. Robert Lewis Emery, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 |