Richard L Wiesemann (NPI# 1629220488, PAC ID# 1850430810) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1629220488 |
| PAC ID by PECOS | 1850430810 |
| Professional Enrollment ID | I20091209000159 |
| Full Name | Richard L Wiesemann |
| Organization Legal Name | FIVE VALLEYS UROLOGY |
| Address |
2875 Tina Rd Suite 101 Missoula MT 59808 |
| Phone Number | 40672833665651 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3870497571 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 270014 | ST. PATRICK HOSPITAL |
| 270023 | COMMUNITY MEDICAL CENTER |
| 271340 | MARCUS DALY MEMORIAL HOSPITAL - CAH |
| 271323 | CLARK FORK VALLEY HOSPITAL |
| 271343 | PROVIDENCE ST JOSEPH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2875 Tina Rd, Suite 101, Missoula, MT 59808 | 40672833665651 | FIVE VALLEYS UROLOGY |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_048_overall | Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older | 100% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 65% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 87% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 95% |
| Organization Legal Name | FIVE VALLEYS UROLOGY |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey Devin Redshaw | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Karl Roy Westenfelder | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Kevin M Kronner | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Whitney C Martin | Physician Assistant | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Christopher George Wicher | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Garrick Richard Simmons | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Street Address |
2875 TINA RD SUITE 101 |
| City | MISSOULA |
| State | MT |
| Zip | 59808 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey Devin Redshaw | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Karl Roy Westenfelder | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Kevin M Kronner | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Whitney C Martin | Physician Assistant | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Christopher George Wicher | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Garrick Richard Simmons | Urology | Five Valleys Urology | 2875 Tina Rd, Suite 101, Missoula, MT 59808 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David I Croteau | Family Medicine | Rchp Billings - Missoula LLC | 2230 N Reserve St, Suite 402, Missoula, MT 59808-1364 |
| Karin M Johns | Physician Assistant | Rchp Billings - Missoula LLC | 2230 N Reserve St, Suite 402, Missoula, MT 59808-1364 |
| Kelly Marie Gregory | Nurse Practitioner | Rchp Billings - Missoula LLC | 2230 N Reserve St, Suite 402, Missoula, MT 59808-1364 |
| Don J Benton | Nurse Practitioner | Rchp Billings - Missoula LLC | 2230 N Reserve St, Suite 402, Missoula, MT 59808-1364 |
| Kelly Foster | Nurse Practitioner | Rchp Billings - Missoula LLC | 2230 N Reserve St, Missoula, MT 59808-1364 |
| Carlyn A Doyle | Nurse Practitioner | Rchp Billings - Missoula LLC | 2230 N Reserve St, Missoula, MT 59808-1364 |
| John M Smith | Rheumatology | Rchp Billings - Missoula LLC | 2230 N Reserve St, Missoula, MT 59808-1364 |
| Michelle Bailey | Physician Assistant | Rchp Billings - Missoula LLC | 2230 N Reserve St, Missoula, MT 59808-1364 |
| Mark Alan Dunifer | Physical Therapy | 3620 American Way, Advantage Therapy, Missoula, MT 59808-1379 | |
| Ursula Encell Holloway | Clinical Social Worker | Providence Health and Services Mt | 3075 N Reserve St Q, Grant Creek Primary Care, Missoula, MT 59808-1390 |
| Find all physicians in zip 59808 | |||
| City | MISSOULA |
| Zip Code | 59808 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MISSOULA + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Richard L Wiesemann.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.