Kevin Brantley Wise, MD is a medicare enrolled "Surgery" physician in Millcreek, Utah. He went to Vanderbilt University School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Intensive Care Consortium Inc, Urgent Specialty Associates Of Utah Pllc and his current practice location is
1200 E 3900 S Ste 4e, Millcreek, Utah. You can reach out to his office (for appointments etc.) via phone at
(385) 347-3773.
Kevin Brantley Wise is licensed to practice in Utah (license number 13005654-1205) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1427344233.
Physician's Profile
| Full Name | Kevin Brantley Wise |
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| Gender | Male |
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| Speciality | General Surgery |
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| Experience | 13 Years |
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| Location | 1200 E 3900 S Ste 4e, Millcreek, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kevin Brantley Wise attended and graduated from Vanderbilt University School Of Medicine in 2011
NPI Data:
- NPI Number: 1427344233
- Provider Enumeration Date: 06/21/2011
- Last Update Date: 03/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 1658528187
- Enrollment ID: I20221209002030
Medical Identifiers
Medical identifiers for Kevin Brantley Wise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1427344233 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 55513 (Minnesota) | Secondary |
| 2086S0102X | Surgery - Surgical Critical Care | 13005654-1205 (Utah) | Secondary |
| 2086S0127X | Surgery - Trauma Surgery | Q8190 (Texas) | Secondary |
| 208600000X | Surgery | 13005654-1205 (Utah) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Intensive Care Consortium Inc | 0244269413 | 370 |
| Urgent Specialty Associates Of Utah Pllc | 3476904442 | 4 |
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. Kevin Brantley Wise allows following entities to bill medicare on his behalf.
| Entity Name | Intensive Care Consortium Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629019062
PECOS PAC ID: 0244269413
Enrollment ID: O20160210001913 |
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| Entity Name | Urgent Specialty Associates Of Utah Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992587778
PECOS PAC ID: 3476904442
Enrollment ID: O20240104001273 |
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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. Kevin Brantley 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 |
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Kevin Brantley Wise, MD
1220 E 3900 S Ste 4e,
Millcreek, UT 84124-1343
Ph: (385) 347-3773 | Kevin Brantley Wise, MD
1200 E 3900 S Ste 4e,
Millcreek, UT 84124-1300
Ph: (385) 347-3773 |
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