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

Theodore Wiesner, MD

Individual provider Emergency Medicine Physician · NPI 1497173389

Theodore Wiesner, MD is an Emergency Medicine in Denver, Colorado. Qualified in 2014, 12 years ago. Practices with Ihc Beaver Dam Emergency Physicians, LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
12
Licensed in
CO
In the registry since
2014
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

777 Bannock St
Denver, CO 80204
Phone: (303) 436-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence DR.0058658 (CO)

Record details

NPI number1497173389
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 28, 2014
Last updated in NPPESAugust 10, 2026
Certification dateAugust 10, 2026
Mailing address450 W 14th Ave Unit 48004, Denver, CO 80204-6244

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Ihc Beaver Dam Emergency Physicians, Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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