Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154304939 Individual Practitioner Male Practitioner

Dr. Mark L Wiesner , DO

Pediatrics • Estes Park, CO

Professional Overview & Biography Verified Profile Summary

Dr. Mark Wiesner, DO is a registered healthcare professional specializing in Pediatrics in Estes Park, CO. Practice services are available at 122 STANLEY CIRCLE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

122 Stanley Circle Dr

Estes Park, CO 805176302

Telephone 9706851148

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Estes Park, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
2 Specialists

Practicing in Estes Park, CO (1195 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-02
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CO 31069

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0725614 (IA)
Medicaid State Provider ID
01310697 (CO)
Medicaid State Provider ID
107825900 (WY)
Commercial Insurance / Payer ID Anthem Bcbs
WIA4011 (CO)
Commercial Insurance / Payer ID Champus
841287602 (CO)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location June 02, 2026

Registered at 122 STANLEY CIRCLE DR, ESTES PARK, CO 805176302 (Tel: 9706851148)

📍
Updated Business Mailing Address June 02, 2026

Registered at 122 STANLEY CIRCLE DR, ESTES PARK, CO 805176302 (Tel: 9706851148)

NPI Profile Active August 28, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location August 28, 2013

Registered at 555 PROSPECT AVE, ESTES PARK, CO 805176312 (Tel: 9705862200)

📍
Updated Business Mailing Address August 28, 2013

Registered at 555 PROSPECT AVE, ESTES PARK, CO 805176312 (Tel: 9705862200)

👤
Provider Name / Credentials Updated August 28, 2013

Recorded as MARK WIESNER, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2013

Pediatrics (License #31069 in CO)

🟢
Initial NPI Registration & Enumeration November 25, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154304939
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 25, 2005
Last Update: June 02, 2026
Sole Proprietor: No

Mailing Address

122 Stanley Circle Dr

Estes Park, CO 805176302

Phone: 9706851148

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.