DANIEL L WISE, PH.D., PA
NPI 1528636511
Psychologist - Clinical in Edina, MN
About Daniel L Wise, Ph.d., Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DANIEL L WISE, PH.D., PA (NPI 1528636511) is a healthcare organization registered as a clinical in Edina, Minnesota and active in the NPI registry since June 2021. The organization maintains a secondary practice location in Minneapolis and lists Daniel Wise, President/licensed Psychologist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Daniel L Wise, Ph.d., Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Daniel L Wise, Ph.D., PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Daniel L Wise, Ph.D., PA's NPI number?
The NPI number for Daniel L Wise, Ph.D., PA is 1528636511. It was assigned to this organization in the NPPES registry on June 15, 2021.
Where is Daniel L Wise, Ph.D., PA located?
Daniel L Wise, Ph.D., PA is located at 5200 Willson Rd Ste 205, Edina, MN 55424. The listed phone number is (612) 875-4449.
What is Daniel L Wise, Ph.D., PA's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Daniel L Wise, Ph.D., PA enrolled in Medicare?
Yes. Daniel L Wise, Ph.D., PA is registered in the Medicare PECOS enrollment system.
When is Daniel L Wise, Ph.D., PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Minnesota, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Daniel L Wise, Ph.D., PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Daniel L Wise, Ph.D., PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Daniel L Wise, Ph.D., PA was last updated on August 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Daniel L Wise, Ph.d., Pa · NPI 1528636511
Clinical organization in Edina, Minnesota. Organization record, active in the CMS NPPES registry since June 15, 2021.
## Identity
- **NPI:** 1528636511 (Entity type: Organization)
- **Enumerated:** June 15, 2021
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Daniel Wise, PRESIDENT/LICENSED PSYCHOLOGIST
## Practice location
- **Address:** 5200 WILLSON RD STE 205, Edina, MN 55424-1343
- **Phone:** (612) 875-4449
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Minnesota, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 24, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1528636511) · Data from the CMS NPPES public registry.