LOLA MUDGISTRATOVA WISE MD
NPI 1609309533
Emergency Medicine in Renton, WA
About Lola Mudgistratova Wise Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LOLA MUDGISTRATOVA WISE MD (NPI 1609309533) is an individual emergency medicine provider in Renton, Washington, licensed in Washington (MD60963016) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with Overlake Hospital Medical Center, and is a graduate of University Of Washington School Of Medicine (2017).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Lola Mudgistratova Wise Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Overlake Hospital Medical Center
Acute Care Hospitals · Bellevue, WAValley Medical Center
Acute Care Hospitals · Renton, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98055 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RENTON, WA 98055
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 Lola Wise's NPI number?
The NPI number for Lola Wise is 1609309533. It was assigned to this individual provider in the NPPES registry on April 7, 2017.
Where is Lola Wise located?
Lola Wise practices at 400 S 43rd St, Renton, WA 98055. The listed phone number is (206) 661-2563.
What is Lola Wise's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Lola Wise enrolled in Medicare?
Yes. Lola Wise is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Lola Wise affiliated with any hospitals?
According to CMS data, Lola Wise is affiliated with Overlake Hospital Medical Center and Valley Medical Center.
When was this NPI record last updated?
The NPPES record for Lola Wise was last updated on January 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.
# Lola Mudgistratova Wise, MD · NPI 1609309533
Emergency Medicine physician in Renton, Washington. Individual provider, active in the CMS NPPES registry since April 7, 2017.
## Identity
- **NPI:** 1609309533 (Entity type: Individual)
- **Enumerated:** April 7, 2017
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** MD60963016 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 400 S 43RD ST, Renton, WA 98055-5714
- **Phone:** (206) 661-2563
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Washington School Of Medicine, class of 2017
## Record status
- **NPPES last updated:** January 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1609309533) · Data from the CMS NPPES public registry.