LISA M WIEDEL MD
NPI 1831166966
Obstetrics & Gynecology in Saint Johns, FL
About Lisa M Wiedel Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISA M WIEDEL MD (NPI 1831166966) is an individual obstetrics & gynecology provider in Saint Johns, Florida, licensed in Florida (ME110534) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lisa M Wiedel Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
6Medicare enrollment records show Lisa Wiedel reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fleming Island, FL 32003
- Reassigned Medicare billing, Florida enrollment
- 683 clinicians in this Medicare group
St Augustine, FL 32086
- Reassigned Medicare billing, Florida enrollment
- 8 clinicians in this Medicare group
Daytona Beach, FL 32114
- Reassigned Medicare billing, Florida enrollment
- 786 clinicians in this Medicare group
Camden, TN 38320
- Reassigned Medicare billing, Tennessee enrollment
- 109 clinicians in this Medicare group
Jackson, TN 38301
- Reassigned Medicare billing, Tennessee enrollment
- 92 clinicians in this Medicare group
Jackson, TN 38301
- Reassigned Medicare billing, Tennessee enrollment
- 54 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32259 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 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, FL 32259
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 Lisa Wiedel's NPI number?
The NPI number for Lisa Wiedel is 1831166966. It was assigned to this individual provider in the NPPES registry on March 8, 2006.
Where is Lisa Wiedel located?
Lisa Wiedel practices at 450 State Road 13 Ste 106-128, Saint Johns, FL 32259. The listed phone number is (904) 616-8410.
What is Lisa Wiedel's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Lisa Wiedel enrolled in Medicare?
Yes. Lisa Wiedel is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Lisa Wiedel's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Wiedel reassigns Medicare benefits to 6 organizations: Ob Hospitalist Group LLC (Fleming Island, FL), Flagler Ob Gyn PA (St Augustine, FL), Halifax Healthcare Systems Inc (Daytona Beach, FL), Wt Medical Associates (Camden, TN), Obhg Tennessee, P.C. (Jackson, TN) and 1 more organization, listed in the Medicare section above. Each 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 Lisa Wiedel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lisa Wiedel accept?
Health plans from AmeriHealth Caritas Next, BlueCross BlueShield of Tennessee, Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 4 other insurers list Lisa Wiedel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lisa Wiedel was last updated on March 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Lisa M Wiedel, MD · NPI 1831166966
Obstetrics & Gynecology physician in Saint Johns, Florida. Individual provider, active in the CMS NPPES registry since March 8, 2006.
## Identity
- **NPI:** 1831166966 (Entity type: Individual)
- **Enumerated:** March 8, 2006
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** ME110534 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 450 STATE ROAD 13, STE 106-128, Saint Johns, FL 32259-3860
- **Phone:** (904) 616-8410
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Ob Hospitalist Group LLC (NPI 1609760099, Fleming Island, FL); Flagler Ob Gyn PA (NPI 1598910606, St Augustine, FL); Halifax Healthcare Systems Inc (NPI 1245283530, Daytona Beach, FL); Wt Medical Associates (NPI 1356021026, Camden, TN); Obhg Tennessee, P.C. (NPI 1285924977, Jackson, TN); and 1 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1831166966) · Data from the CMS NPPES public registry.