Dr Deena Renae Wise, DO - Medicare Pediatrics in Lagrange, GA

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Dr Deena Renae Wise, DO is a medicare enrolled "Pediatrics" physician in Lagrange, Georgia. Her current practice location is 1514 Vernon Rd, Lagrange, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 845-3132.

Dr Deena Renae Wise is licensed to practice in Georgia (license number 86763) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982683488.

Contact Information

Dr Deena Renae Wise, DO
1514 Vernon Rd,
Lagrange, GA 30240-4131
(770) 845-3132
Not Available

Map and Direction




Physician's Profile

Full NameDr Deena Renae Wise
GenderFemale
SpecialityPediatrics
Location1514 Vernon Rd, Lagrange, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1982683488
  • Provider Enumeration Date: 01/12/2006
  • Last Update Date: 04/17/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7517031115
  • Enrollment ID: I20181023003362

Medical Identifiers

Medical identifiers for Dr Deena Renae Wise such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982683488NPI-NPPES
100877500MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 2002008852 (Missouri)Secondary
208000000XPediatrics OS15511 (Florida)Secondary
208000000XPediatrics 3820 (Oklahoma)Secondary
208000000XPediatrics 05305 (Kentucky)Secondary
208000000XPediatrics 2020-03433 (North Carolina)Secondary
208M00000XHospitalist OS15511 (Florida)Secondary
208000000XPediatrics 86763 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Deena Renae Wise allows following entities to bill medicare on her behalf.
Entity NameFlorida Hospital Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225034234
PECOS PAC ID: 0749186153
Enrollment ID: O20031208000807
Entity NameNorth Okaloosa Clinic Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659329852
PECOS PAC ID: 0244205565
Enrollment ID: O20040831000576
Entity NameBaptist Physician Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235128646
PECOS PAC ID: 3577518398
Enrollment ID: O20050315000387
Entity NameHospital Physician Services Of Florida Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558718635
PECOS PAC ID: 7012201965
Enrollment ID: O20160816000476

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Deena Renae Wise is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Deena Renae Wise, DO
1738 Wren Way,
Niceville, FL 32578-7102

Ph: () -		Dr Deena Renae Wise, DO
1514 Vernon Rd,
Lagrange, GA 30240-4131

Ph: (770) 845-3132

Reviews and Comments


Pediatrics Doctors in Lagrange, GA

Eric James Zerla, M.D.
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Practice Location: 1550 Doctors Dr, Suite 300, Lagrange, GA 30240
Phone: 706-884-2686    Fax: 706-812-0468
Kalyani Rajeev, MD
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Practice Location: 301 Medical Dr, Suite 504, Lagrange, GA 30240
Phone: 706-882-5437    
Holly Mcmahon Dawson, M.D.
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Practice Location: 1514 Vernon Rd, Lagrange, GA 30240
Phone: 706-812-2369    
Diana L Hess, CNP
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Medicare: Not Enrolled in Medicare
Practice Location: 205 Calumet Center Rd, Lagrange, GA 30241
Phone: 706-885-1961    Fax: 706-885-1963
Joseph Morris Almand Jr., M.D.
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Medicare: Not Enrolled in Medicare
Practice Location: 1550 Doctors Dr, Suite 300, Lagrange, GA 30240
Phone: 706-884-2686    Fax: 706-812-0468
George John Lechacz, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 1550 Doctors Dr, Suite 300, Lagrange, GA 30240
Phone: 706-884-2686    Fax: 706-812-0468
Dr. Nicole Dupraw Carter, M.D.
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Medicare: Not Enrolled in Medicare
Practice Location: 301 Medical Dr Ste 504, Lagrange, GA 30240
Phone: 706-812-2655    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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