JENNIFER RENEE WISE (MD) – Internal Medicine Physician, NPI 1255326252
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JENNIFER RENEE WISE (MD)
Sky Lakes Medical Center, 2865, Daggett Avenue, Klamath Falls, Klamath County, Oregon, 97601, United States
KLAMATH FALLS, OR 976011106
Phone: (541) 274-8400
Fax: (541) 274-8405
Type: Mailing
275 Mammoth Rd
SUITE 4
Manchester, NH 031094133
Phone: (603) 624-4380
Fax: (603) 624-4805
Type: Location
2821 DAGGETT AVE STE 200
KLAMATH FALLS, OR 976011106
Phone: (541) 274-8400
Fax: (541) 274-8405
Type: Location
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: 2021-10-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190716002141 | I | Internal Medicine | OR | TBD |
| I20211028001446 | I | Internal Medicine | NM | TBD |
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.
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 97601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Family Practice | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| Internal Medicine | OR | |
| Family Practice | OR | |
| - | OR | |
| - | OR | |
| Neurology, Neuropsychiatry | FL | |
| Diagnostic Radiology | OR |
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