Dustin Bryant Wise, MD in Pleasant Grove, UT

Dustin Bryant Wise, MD is a medicare enrolled "Pediatrics" physician in Pleasant Grove, Utah. His current practice location is 1888 W 800 N, Pleasant Grove, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 492-7851.

Dustin Bryant Wise is licensed to practice in Utah (license number 52479661205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1811945769.

Contact Information

	Dustin Bryant Wise, MD
	1888 W 800 N, Pleasant Grove, UT 84062-4097
	(801) 492-7851
	(801) 492-7883

Map and Direction

Physician's Profile

Full Name	Dustin Bryant Wise
Gender	Male
Speciality	Pediatrics
Location	1888 W 800 N, Pleasant Grove, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811945769
Provider Enumeration Date: 05/04/2006
Last Update Date: 09/09/2021

Medicare PECOS Information:

PECOS PAC ID: 6406076629
Enrollment ID: I20141009001708

Medical Identifiers

Medical identifiers for Dustin Bryant Wise such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811945769	NPI	-	NPPES
107017722102	Other	UT	IHC HEALTH PLANS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	52479661205 (Utah)	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. Dustin Bryant Wise allows following entities to bill medicare on his behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303

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. Dustin Bryant 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 Address	Practice Location Address
Dustin Bryant Wise, MD 1888 W 800 N, Pleasant Grove, UT 84062 Ph: (801) 492-7851	Dustin Bryant Wise, MD 1888 W 800 N, Pleasant Grove, UT 84062-4097 Ph: (801) 492-7851

Reviews and Comments

Pediatrics Doctors in Pleasant Grove, UT

Jeffery H Abram, PA-C Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
David Todd Whiting, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
Greg Matthew Pavich, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
William Foster Edwards, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
Brett Kelsey Knorr, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
David Sterling Johnson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991
Beverly L Vargo, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1912 W 930 N, Pleasant Grove, UT 84062 Phone: 801-492-1999 Fax: 801-492-1991

Dustin Bryant Wise, MD - Medicare Pediatrics in Pleasant Grove, UT