Shannon McVey Wiedersum, D.O

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS019788 Issued in PA

Practice address

252 W Swamp Rd Ste 48
Doylestown, PA 18901-2408

Phone

(215) 230-9988

Fax

(215) 230-9989

NPI assigned

May 26, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Philadelphia College of Osteopathic Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary B Toporcer, MD,PCGroup PAC ID 0547360026, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drwiedersum@marybtoporcermd.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary B Toporcer, MD,PC

  • Dermatology Physician
  • Doylestown, PA
  • NPI 1346263738
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doylestown Hospital

  • General Acute Care Hospital
  • Doylestown, PA
  • NPI 1225091697
  Care Compare affiliation
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1013396944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 W SWAMP RD STE 48",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012408",
            "telephone_number": "215-230-9988",
            "fax_number": "215-230-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 W SWAMP RD STE 48",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012408",
            "telephone_number": "215-230-9988",
            "fax_number": "215-230-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERSUM",
        "first_name": "SHANNON",
        "middle_name": "MCVEY",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS019788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drwiedersum@marybtoporcermd.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "referring patients, provide records to primary care physician, compliance with mips",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "csv,",
            "address_1": "252 W Swamp Rd Ste 48",
            "city": "Doylestown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189012408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drwiedersum@marybtoporcermd.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "referring patients, providing records to PCP, compliance with MIPs",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV, XML, HL7",
            "address_1": "252 W Swamp Rd Ste 48",
            "city": "Doylestown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189012408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sarah White, PA-C
• Joanne York Whitworth, MA, NCC, LPC
• Whole Heart Healing LLC
• Whole Person Services LLC
• George Wiemann, M.D, FACC
• Philip Wiener, D.O.
• Alisa Wiggins
• William Stover Wiggins, M.D.
• Bruce Wilderman, D.D.S.

• Dermatology Physician in Doylestown, PA
• Providers in Doylestown, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.