Frederick Keyser Wiese, MD is a medicare enrolled "Internal Medicine" physician in Canaan, New Hampshire. His current practice location is
18 Roberts Road, Canaan, New Hampshire. You can reach out to his office (for appointments etc.) via phone at
(603) 523-4343.
Frederick Keyser Wiese is licensed to practice in New Hampshire (license number 6868) 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 1194739672.
Physician's Profile
Full Name | Frederick Keyser Wiese |
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Gender | Male |
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Speciality | Internal Medicine |
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Location | 18 Roberts Road, Canaan, New Hampshire |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1194739672
- Provider Enumeration Date: 07/28/2006
- Last Update Date: 12/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 0547340853
- Enrollment ID: I20190410002560
Medical Identifiers
Medical identifiers for Frederick Keyser Wiese such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194739672 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RC0000X | Internal Medicine - Cardiovascular Disease | 6868 (New Hampshire) | Secondary |
207R00000X | Internal Medicine | 6868 (New Hampshire) | 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. Frederick Keyser Wiese allows following entities to bill medicare on his behalf.
Entity Name | Mascoma Community Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497298087 PECOS PAC ID: 2466736525 Enrollment ID: O20170309000707 |
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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. Frederick Keyser Wiese 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 |
Frederick Keyser Wiese, MD 18 Roberts Road, Canaan, NH 03741-1079 Ph: (603) 523-4343 | Frederick Keyser Wiese, MD 18 Roberts Road, Canaan, NH 03741 Ph: (603) 523-4343 |
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