| Mr Michael B Wiese, MD | |
|
5719 Widewaters Pkwy, Syracuse, NY 13214-1985 | |
| (315) 251-3100 | |
| (315) 449-9923 |
| Full Name | Mr Michael B Wiese |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 40 Years |
| Location | 5719 Widewaters Pkwy, Syracuse, New York |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538137005 | NPI | - | NPPES |
| 01499807 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 175162 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kindred At Home (liverpool) | Liverpool, NY | Home health agency |
| Crouse Hospital | Syracuse, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Orthopedics East, Pc | 3375512320 | 2 |
| Select Pt, Ot And Slp Rehabilitation Ny, Pllc | 3870986656 | 138 |
| Entity Name | Orthopedics East, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932266806 PECOS PAC ID: 3375512320 Enrollment ID: O20040928000156 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael B Wiese, MD Po Box 580, Syracuse, NY 13214-0580 Ph: (315) 251-3140 | Mr Michael B Wiese, MD 5719 Widewaters Pkwy, Syracuse, NY 13214-1985 Ph: (315) 251-3100 |
David Anthony Distefano, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 Fax: 315-449-9923 | |
Jalal Sadrieh, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 4900 Broad Rd, Ste North3e, Syracuse, NY 13215 Phone: 315-492-5864 Fax: 315-492-5285 | |
James Alan Lemley, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 Fax: 315-449-9923 | |
Frederick R. Lemley, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 Fax: 315-449-9923 | |
Justin Iorio, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 | |
Cassandra Riggs, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 | |
Dr. Brad Raphael, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5719 Widewaters Pkwy, Syracuse, NY 13214 Phone: 315-251-3100 Fax: 315-449-9923 |