Deactivated NPI 1487882270 Deactivated / Inactive NPI Female Practitioner

Dr. Emily Michelle Wise , MD

Dermatology • Wellesley, MA

✓ Accepts Medicare Assignment

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Emily Wise has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 30, 2009

NPI Deactivation Date January 03, 2019

Total Practice Duration ~10 Years of Practice (2009 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Emily Wise, MD was a registered Dermatology in Wellesley, MA. Prior to record deactivation on 2019-01-03, Dr. Wise completed approximately 10 years of clinical practice following graduation from Boston University School Of Medicine in 2009.

Dr. Wise was affiliated with Dermwellesley Llc and accepted Medicare assignment.

Historical Medicare Part B clinical services included destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

20 William St Ste G15

Wellesley, MA 024814102

Telephone 7815914234

Fax 7813699737

Associated Practice Facility / Clinic

🏢 Dermwellesley Llc Facility NPI 1811478092

Medicare Profile & Education

Medical School

Boston University School Of Medicine

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Wellesley, MA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -5.0 yrs vs City Avg

City Avg: 22.0 Yrs

State Avg: 27.5 Yrs

Regional Practice Density

27 Specialists

Practicing in Wellesley, MA (648 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

69.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wise (17 Years) 17 Yrs

Wellesley Specialty Average (22.0 Years) 22.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	773	183	$35.00	$7.62
99213 Established patient office or other outpatient visit, typically 15 minutes	573	428	$320.00	$99.33
17000 Destruction of skin growth	330	229	$280.00	$68.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	195	167	$425.00	$139.65
11102 Tangential biopsy of single skin lesion	144	130	$345.00	$112.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	50	50	$425.00	$119.79
11103 Biopsy of related skin growth, each additional growth	43	35	$186.00	$56.71
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	42	41	$225.00	$62.33
17110 Destruction of up to 14 skin growths	35	31	$425.00	$128.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$650.00	$181.11
11104 Punch biopsy, first skin growth	19	18	$400.00	$141.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	800	172	$35.00	$7.80
99213 Established patient office or other outpatient visit, typically 15 minutes	511	375	$320.00	$99.45
17000 Destruction of skin growth	328	226	$280.00	$67.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	201	148	$425.00	$140.45
11102 Tangential biopsy of single skin lesion	190	166	$345.00	$114.68
17110 Destruction of up to 14 skin growths	67	49	$425.00	$132.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$425.00	$123.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	53	$225.00	$63.08
11103 Biopsy of related skin growth, each additional growth	52	39	$186.00	$58.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$650.00	$182.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	829	166	$35.00	$8.03
99213 Established patient office or other outpatient visit, typically 15 minutes	443	325	$320.00	$101.48
17000 Destruction of skin growth	300	209	$280.00	$67.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	195	150	$425.00	$142.75
11102 Tangential biopsy of single skin lesion	156	135	$345.00	$113.98
17110 Destruction of up to 14 skin growths	90	51	$425.00	$133.13
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	76	76	$425.00	$125.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	42	$225.00	$63.88
11103 Biopsy of related skin growth, each additional growth	44	32	$186.00	$60.17
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$650.00	$185.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	739	137	$35.00	$7.73
99213 Established patient office or other outpatient visit, typically 15 minutes	389	289	$320.00	$102.85
17000 Destruction of skin growth	270	183	$280.00	$66.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	139	112	$425.00	$143.54
11102 Tangential biopsy of single skin lesion	134	122	$345.00	$119.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	95	95	$425.00	$126.36
17110 Destruction of up to 14 skin growths	45	37	$425.00	$135.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	39	$225.00	$63.43
11103 Biopsy of related skin growth, each additional growth	23	18	$186.00	$62.52
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$650.00	$187.56
17004 Destruction of precancer skin growth, 15 or more growths	17	12	$520.00	$194.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	608	112	$35.00	$7.08
99213 Established patient office or other outpatient visit, typically 15 minutes	270	203	$320.00	$84.28
17000 Destruction of skin growth	229	168	$280.00	$68.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	153	153	$425.00	$120.75
11102 Tangential biopsy of single skin lesion	121	109	$345.00	$115.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	74	$425.00	$120.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	49	44	$225.00	$51.30
99202 New patient office or other outpatient visit, typically 20 minutes	36	36	$320.00	$85.85
11103 Biopsy of related skin growth, each additional growth	32	27	$186.00	$62.23
17110 Destruction of up to 14 skin growths	28	24	$425.00	$124.57
17004 Destruction of precancer skin growth, 15 or more growths	16	13	$520.00	$184.11
11104 Punch biopsy, first skin growth	16	16	$435.00	$147.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	457	96	$35.00	$6.45
99213 Established patient office or other outpatient visit, typically 15 minutes	279	188	$320.00	$82.22
17000 Destruction of skin growth	195	131	$280.00	$66.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	93	93	$425.00	$119.74
11102 Tangential biopsy of single skin lesion	86	77	$345.00	$112.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	64	52	$425.00	$119.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	43	$225.00	$50.53
99202 New patient office or other outpatient visit, typically 20 minutes	28	28	$320.00	$84.93
11103 Biopsy of related skin growth, each additional growth	23	17	$186.00	$60.96
17110 Destruction of up to 14 skin growths	22	19	$425.00	$127.06
11104 Punch biopsy, first skin growth	13	13	$435.00	$142.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	447	99	$35.00	$6.02
99213 Established patient office or other outpatient visit, typically 15 minutes	297	225	$320.00	$80.96
17000 Destruction of skin growth	206	143	$280.00	$68.06
11100 Biopsy of single growth of skin and/or tissue	90	81	$380.00	$120.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	76	74	$425.00	$119.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	52	52	$425.00	$119.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	49	$200.00	$49.27
17110 Destruction of up to 14 skin growths	23	20	$425.00	$129.12
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$320.00	$83.52
11101 Biopsy of each additional growth of skin and/or tissue	15	11	$150.00	$36.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	473	107	$35.00	$6.31
99213 Established patient office or other outpatient visit, typically 15 minutes	298	238	$282.25	$79.60
17000 Destruction of skin growth	197	147	$250.91	$67.89
11100 Biopsy of single growth of skin and/or tissue	96	85	$351.56	$115.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	61	$383.06	$116.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	52	52	$386.54	$117.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	44	37	$160.23	$48.07
17110 Destruction of up to 14 skin growths	42	32	$390.83	$125.27
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$285.91	$81.78
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	18	16	$483.33	$157.84
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	18	16	$444.44	$355.10
11101 Biopsy of each additional growth of skin and/or tissue	16	12	$128.13	$35.64

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License MA 254256

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology - Procedural Dermatology

NUCC Taxonomy Code: 207NS0135X

State License MA 254256

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Npi

1487882270

Hospital & Practice Group Affiliations

Dermwellesley Llc

20 William St, Wellesley, MA 024814102

Phone: 7815914234

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Dr. Jacqueline Goldminz , MD

Dermatology

NPI 1215466719

Doctor of Medicine (M.D.)

Barbara Stjohn , NP

Nurse Practitioner - Primary Care

NPI 1275886285

Nurse Practitioner

Dr. Caren Droesch , MD

Dermatology

NPI 1396193777

Doctor of Medicine (M.D.)

Dr. Sara Berg , MD

Dermatology

NPI 1750776712

Doctor of Medicine (M.D.)

Dr. Lindsay Mccormack , MD

Dermatology

NPI 1831765148

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events

🔄

NPI Profile Reactivated January 08, 2019

Record officially reactivated for active practice on January 08, 2019

📍

Updated Practice Location January 08, 2019

Registered at 20 WILLIAM ST STE G15, WELLESLEY, MA 024814102 (Tel: 7815914234)

📍

Updated Business Mailing Address January 08, 2019

Registered at 20 WILLIAM ST STE G15, WELLESLEY, MA 024814102 (Tel: 7815914234)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2019

Dermatology (License #254256 in MA)

⚠️

NPI Profile Deactivated January 03, 2019

Record deactivated on January 03, 2019

✅

NPI Profile Active January 05, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location January 05, 2017

Registered at 1 WASHINGTON ST, SUITE#401, WELLESLEY HILLS, MA 024811711 (Tel: 7814133500)

📍

Updated Business Mailing Address January 05, 2017

Registered at 8 GLEN BROOK RD, WELLESLEY, MA 024811428 (Tel: 7814163500)

👤

Provider Name / Credentials Updated January 05, 2017

Recorded as EMILY WISE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2017

Dermatology (License #254256 in MA)

🟢

Initial NPI Registration & Enumeration June 30, 2009

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: 1487882270

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 30, 2009

Last Update: January 08, 2019

Deactivation Date: January 03, 2019

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

20 William St Ste G15

Wellesley, MA 024814102

Phone: 7815914234

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

⚠️ Medical Disclaimer

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