Active NPI 1831317346 Individual Practitioner Male Practitioner

Dr. Jacob Anthony Wiesen , MD

General Practice • Fremont, NE

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Wiesen, MD is a certified General Practice practicing in Fremont, NE. With approximately 20 years of clinical experience since graduating from University Of Nebraska College Of Medicine in 2006, Dr. Wiesen delivers high-quality medical care to the local community at 2540 N HEALTHY WAY.

Dr. Wiesen is affiliated with North Platte Nebraska Hospital Corporation and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2540 N Healthy Way

Fremont, NE 680252315

Telephone 4027216333

Associated Practice Facility / Clinic

🏢 Fremont Health Clinic Facility NPI 1053858860

Medicare Profile & Education

Medical School

University Of Nebraska College Of Medicine

Graduation Year

2006

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Fremont, NE

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

20 Yrs Matches City Avg

City Avg: 20.0 Yrs

State Avg: 27.6 Yrs

Regional Practice Density

1 Specialists

Practicing in Fremont, NE (56 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

84.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wiesen (20 Years) 20 Yrs

Fremont Specialty Average (20.0 Years) 20.0 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
99213 Established patient office or other outpatient visit, typically 15 minutes	329	183	$186.00	$60.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	70	$265.00	$89.06
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	75	74	$1217.00	$70.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	68	$281.00	$118.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$228.00	$73.77
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	70	45	$156.00	$72.05
45380 Biopsy of large bowel using an endoscope	66	66	$1392.00	$148.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	55	55	$342.00	$119.80
45378 Diagnostic exam of large bowel using a flexible endoscope	42	42	$1080.00	$157.82
11042 Removal of skin and tissue, 20.0 sq cm or less	36	22	$184.00	$54.23
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	27	27	$1448.00	$224.87
97597 Removal of tissue from wound, 20.0 sq cm or less	27	16	$82.00	$32.36
43249 Balloon dilation of esophagus using an endoscope	23	20	$3571.00	$130.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	21	$115.00	$32.24
76937 Ultrasonic guidance for blood vessel access	17	16	$48.00	$12.49
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	17	16	$227.35	$16.09
99231 Follow-up hospital inpatient care per day, typically 15 minutes	15	14	$97.00	$44.77
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	12	12	$590.00	$163.12
47562 Removal of gallbladder using an endoscope	11	11	$2069.00	$540.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	321	186	$180.00	$61.59
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	125	62	$145.26	$73.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	91	91	$331.25	$124.81
45380 Biopsy of large bowel using an endoscope	82	82	$1392.00	$175.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	77	$256.00	$91.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	75	75	$220.00	$76.96
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	74	70	$273.65	$122.25
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	71	71	$1217.00	$75.57
97597 Removal of tissue from wound, 20.0 sq cm or less	55	33	$80.36	$33.53
45378 Diagnostic exam of large bowel using a flexible endoscope	55	55	$1080.00	$162.39
11042 Removal of skin and tissue, 20.0 sq cm or less	52	25	$184.00	$53.12
99231 Follow-up hospital inpatient care per day, typically 15 minutes	37	15	$79.65	$46.36
76937 Ultrasonic guidance for blood vessel access	25	24	$48.00	$13.04
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	24	23	$369.00	$16.69
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	21	21	$3209.00	$293.62
43245 Dilation of stomach outlet using an endoscope	16	16	$538.00	$139.75
47562 Removal of gallbladder using an endoscope	14	14	$2069.00	$579.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	224	164	$160.00	$63.12
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	204	94	$155.00	$67.15
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	116	116	$351.00	$127.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	116	99	$232.00	$93.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	104	98	$295.00	$126.67
97597 Removal of tissue from wound, 20.0 sq cm or less	86	33	$80.00	$34.29
11042 Removal of skin and tissue, 20.0 sq cm or less	81	29	$133.00	$54.23
45380 Biopsy of large bowel using an endoscope	70	70	$439.00	$158.28
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	70	67	$302.00	$85.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$230.00	$78.06
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	40	36	$205.00	$17.33
76937 Ultrasonic guidance for blood vessel access	38	35	$31.00	$13.13
45378 Diagnostic exam of large bowel using a flexible endoscope	34	34	$405.00	$159.28
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	25	23	$738.00	$290.75
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	15	15	$572.00	$240.13
47562 Removal of gallbladder using an endoscope	15	15	$1454.00	$583.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$97.00	$33.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	238	170	$159.90	$64.13
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	183	95	$154.61	$67.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	152	152	$350.88	$128.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	150	118	$231.91	$93.52
11042 Removal of skin and tissue, 20.0 sq cm or less	129	33	$132.63	$56.21
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	114	107	$294.82	$128.10
45380 Biopsy of large bowel using an endoscope	89	89	$438.81	$133.73
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	82	80	$302.39	$85.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	64	64	$229.66	$78.88
97597 Removal of tissue from wound, 20.0 sq cm or less	52	20	$79.58	$34.53
45378 Diagnostic exam of large bowel using a flexible endoscope	50	50	$405.47	$166.41
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	33	33	$557.04	$234.18
76937 Ultrasonic guidance for blood vessel access	31	30	$31.07	$13.28
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	27	25	$204.93	$17.54
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	18	17	$738.11	$308.85
47562 Removal of gallbladder using an endoscope	16	16	$1453.66	$575.39
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$432.75	$189.29
99231 Follow-up hospital inpatient care per day, typically 15 minutes	13	11	$84.12	$36.43
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$97.01	$34.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	257	107	$155.00	$70.02
99213 Established patient office or other outpatient visit, typically 15 minutes	251	174	$158.00	$49.34
11042 Removal of skin and tissue, 20.0 sq cm or less	106	40	$133.00	$57.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$231.00	$72.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	68	$232.00	$76.38
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	81	77	$292.00	$132.24
45380 Biopsy of large bowel using an endoscope	75	75	$444.00	$160.65
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	71	68	$307.00	$88.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	63	63	$350.00	$124.26
97597 Removal of tissue from wound, 20.0 sq cm or less	44	23	$51.00	$35.93
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	36	$96.00	$24.54
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	30	30	$431.00	$195.90
45378 Diagnostic exam of large bowel using a flexible endoscope	29	29	$409.00	$172.54
76937 Ultrasonic guidance for blood vessel access	23	19	$31.00	$14.11
99231 Follow-up hospital inpatient care per day, typically 15 minutes	22	17	$84.00	$37.79
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	17	17	$564.00	$247.08
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	17	16	$193.00	$18.12
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	15	$271.00	$94.78
47562 Removal of gallbladder using an endoscope	14	14	$1443.00	$599.76
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	11	11	$571.00	$239.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	297	126	$147.75	$68.50
99213 Established patient office or other outpatient visit, typically 15 minutes	283	186	$148.31	$47.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	139	139	$220.35	$71.07
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	116	109	$278.48	$128.52
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	92	92	$311.61	$90.77
45380 Biopsy of large bowel using an endoscope	86	86	$435.26	$181.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	80	$217.98	$74.37
11042 Removal of skin and tissue, 20.0 sq cm or less	80	28	$131.66	$56.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	70	70	$334.80	$120.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	50	$89.28	$23.68
97597 Removal of tissue from wound, 20.0 sq cm or less	40	23	$48.96	$23.15
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	40	$411.77	$190.38
45378 Diagnostic exam of large bowel using a flexible endoscope	29	29	$228.67	$160.21
47562 Removal of gallbladder using an endoscope	26	26	$1370.86	$585.42
76937 Ultrasonic guidance for blood vessel access	22	21	$32.95	$15.38
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	17	16	$186.96	$17.68
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	14	$293.93	$94.51
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	14	12	$206.57	$98.05
43245 Dilation of stomach outlet using an endoscope	14	13	$392.08	$148.15
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	13	12	$611.19	$197.01
36589 Removal of central venous catheter for infusion	11	11	$561.73	$104.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	220	109	$137.00	$68.21
99213 Established patient office or other outpatient visit, typically 15 minutes	118	82	$143.33	$48.37
99213 Established patient office or other outpatient visit, typically 15 minutes	95	71	$131.40	$67.32
11042 Removal of skin and tissue, 20.0 sq cm or less	89	32	$268.00	$58.10
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	75	71	$383.00	$191.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	67	67	$237.00	$99.87
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	65	64	$274.00	$128.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	64	64	$237.00	$71.37
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	56	55	$884.00	$98.08
45380 Biopsy of large bowel using an endoscope	46	46	$1263.00	$191.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	31	$115.22	$23.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	36	32	$96.89	$40.69
97597 Removal of tissue from wound, 20.0 sq cm or less	35	16	$271.00	$23.09
76937 Ultrasonic guidance for blood vessel access	34	34	$50.00	$15.56
45378 Diagnostic exam of large bowel using a flexible endoscope	33	33	$1148.00	$175.99
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	32	30	$804.00	$74.96
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	26	26	$304.00	$17.63
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	25	25	$3913.00	$313.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	23	$204.00	$100.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$335.00	$121.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	20	$204.00	$74.12
99231 Follow-up hospital inpatient care per day, typically 15 minutes	16	13	$83.00	$36.95
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	16	13	$192.00	$98.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$335.00	$153.23
47562 Removal of gallbladder using an endoscope	12	12	$1688.00	$525.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	144	105	$152.61	$47.81
97597 Removal of tissue from wound, 20.0 sq cm or less	135	64	$177.00	$22.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	114	75	$92.03	$23.88
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	89	39	$154.25	$68.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$237.00	$99.45
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	34	34	$285.74	$128.40
99202 New patient office or other outpatient visit, typically 20 minutes	29	29	$157.00	$47.54
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$228.30	$71.31
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	22	22	$413.14	$190.51
47562 Removal of gallbladder using an endoscope	19	19	$1531.68	$516.47
99213 Established patient office or other outpatient visit, typically 15 minutes	18	15	$130.39	$67.84
11042 Removal of skin and tissue, 20.0 sq cm or less	17	13	$252.47	$56.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	16	$204.00	$100.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	13	$226.40	$74.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$344.23	$121.26
45380 Biopsy of large bowel using an endoscope	12	12	$1189.00	$183.47
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$884.00	$102.17

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License NE 5413

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Hospital & Practice Group Affiliations

North Platte Nebraska Hospital Corporation

601 W Leota St, North Platte, NE 691016525

Phone: 3085688000

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Stephen Dreyer , MD

Specialist

NPI 1639177009

Doctor of Medicine (M.D.)

Dr. Keith Leatherbury , MD

Surgery

NPI 1780682153

Doctor of Medicine (M.D.)

Dr. Christopher Gartin , MD

Surgery

NPI 1780948919

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active January 21, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location January 21, 2016

Registered at 2540 N HEALTHY WAY, FREMONT, NE 680252315 (Tel: 4027216333)

📍

Updated Business Mailing Address January 21, 2016

Registered at 2540 N HEALTHY WAY, FREMONT, NE 680252315 (Tel: 4027216333)

👤

Provider Name / Credentials Updated January 21, 2016

Recorded as JACOB WIESEN, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 21, 2016

General Practice (License #5413 in NE)

🟢

Initial NPI Registration & Enumeration April 22, 2007

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: 1831317346

Entity Type:

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

Enumeration Date: April 22, 2007

Last Update: January 21, 2016

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

2540 N Healthy Way

Fremont, NE 680252315

Phone: 4027216333

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

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