Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Beth Thomas Wiedeman, MD

Individual provider Family Medicine Physician · NPI 1295797462

Dr. Beth Thomas Wiedeman, MD is a Family Practice in Fayetteville, New York. Qualified in 1997, 29 years ago. Practices with St Josephs Medical PC, a 385-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
29
Licensed in
NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4000 Medical Center Dr Ste 104
Fayetteville, NY 13066-6635
Phone: (315) 663-0059
Fax: (315) 663-0123
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 211782. (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence 211782 (NY)

Record details

NPI number1295797462
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 4, 2006
Last updated in NPPESMay 26, 2023
Certification dateMay 18, 2023
Mailing address5112 West Taft Road, Suite L, Liverpool, NY 13088

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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