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

Individual provider Family Medicine Physician · NPI 1952988222

Dr. Derek Wiseman, MD is a Family Practice in Roseburg, Oregon. Graduated from Oregon Health Sciences University School of Medicine in 2021, 5 years ago. Practices with Centennial Medical Group East LLC, a 63-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
OR
In the registry since
2021
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

1937 W Harvard Ave
Roseburg, OR 97471-2720
Phone: (541) 677-7200
Fax: (541) 229-3309
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD219665 (OR)

Record details

NPI number1952988222
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2021
Last updated in NPPESAugust 5, 2024
Certification dateAugust 5, 2024
Mailing address2570 Nw Edenbower Blvd Ste 100, Roseburg, OR 97471-6214

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Centennial Medical Group East Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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