JON D WIESE (MD) – Surgery Physician, NPI 1952474561

JON D WIESE (MD) is a healthcare provider. based in Longwood, Florida. specializing in Surgery Physician. They hold the professional credentials MD. They hold a License No. ME54060 (FL). The NPI Number for JON D WIESE (MD) is 1952474561

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
JON D WIESE (MD)
NPI
1952474561
Phone
(407) 767-5808
Address
521 W STATE ROAD 434
Enumeration Date
15 November 2006
Last Update Date
14 November 2016

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
4077675808
Graduation Year
1983 (43 years ago)
PAC ID
1850479502
Group Practice PAC ID
9537059084
Professional Enrollment ID
I20080421000323
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for JON D WIESE (MD)

  • 521, West State Road 434, Longwood, Seminole County, Florida, 32750, United States

    SUITE 301

    LONGWOOD, FL 327505166

    Phone: (407) 767-5808

    Fax: (407) 767-5892

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-04-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080421000323IGeneral SurgeryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32750)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537059084View full group profile
NameSpecialtyState
Internal MedicineFL
O B S T E T R I C S/ G Y N E C O L O G YNY
Nurse PractitionerFL
Internal MedicineFL
Vascular Surgery, General SurgeryFL
Physical Therapist In Private PracticeFL
Sports MedicineOH
Nurse PractitionerFL
Internal MedicineFL
Internal MedicineIA

Reviews

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Frequently asked questions

Is there an official ID for JON D WIESE (MD) in U.S. healthcare records?
The official identifier for JON D WIESE (MD) is NPI 1952474561.
Active or inactive — what applies to JON D WIESE (MD)?
You should see JON D WIESE (MD) as active in CMS-hosted NPPES data.
What area of care is associated with JON D WIESE (MD)?
JON D WIESE (MD)'s record emphasizes Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Florida is JON D WIESE (MD) registered?
Use Longwood, Florida as the headline location for JON D WIESE (MD) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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