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

Tia Rose Wisdo

Individual provider Physician Assistant · NPI 1427642263

Tia Rose Wisdo is a Physician Assistant in Philadelphia, Pennsylvania. Graduated from Philadelphia College of Osteopathic Medicine in 2021, 5 years ago. Practices with Wake Forest University Health Sciences, a 2,621-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
5
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
NC
In the registry since
2021
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Practice location Address checks out

4170 City Ave
Philadelphia, PA 19131
Phone: (215) 871-6100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-12070 (NC)

Record details

NPI number1427642263
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 23, 2021
Last updated in NPPESMarch 15, 2022
Certification dateMarch 15, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2021 (5 years in practice)
Group practice Wake Forest University Health Sciences — 2621 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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