DR. SHANE M WISE PHD
NPI 1831922392
Psychologist - Clinical in Chevy Chase, MD

Q: What is Shane Wise's NPI number?

The NPI number for Shane Wise is 1831922392. It was assigned to this individual provider in the NPPES registry on August 21, 2024.

Q: What is Shane Wise's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Shane Wise enrolled in Medicare?

No. Shane Wise has opted out of Medicare through July 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Shane Wise was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since August 21, 2024Opted out of Medicare · through Jul 17, 2027

8401 CONNECTICUT AVE STE 1120, CHEVY CHASE, MD 20815(301) 593-6554 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 19, 2025, Aug 21, 2024 (2 updates tracked since 2024).

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About Dr. Shane M Wise Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANE M WISE PHD (NPI 1831922392) is an individual clinical provider in Chevy Chase, Maryland, licensed in Maryland (07345) and active in the NPI registry since August 2024. He has opted out of Medicare through July 17, 2027.

NPPES Registry Identity

NPI1831922392

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. SHANE M WISECredential: PHD

Location Address8401 CONNECTICUT AVE STE 1120Chevy Chase, MD 20815-5846

Mailing Address8401 Connecticut Ave Ste 1120Chevy Chase, MD 20815-5846

Phone(301) 593-6554

Sole ProprietorNo

Enumeration DateAugust 21, 2024

Last NPPES UpdateJune 19, 20252 updates tracked since enumeration

NPPES CertifiedJune 19, 2025

✔ NPI 1831922392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MD · 07345

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

8401 CONNECTICUT AVE STE 1120, Chevy Chase, MD 20815

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shane M Wise Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 17, 2025 through July 17, 2027.

Opt-Out Effective DateJuly 17, 2025

Opt-Out In Effect ThroughJuly 17, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RACHEL ELIZABETH WEINSTOCK PHD

Psychologist