Individual provider Active NPI

Andrew James Wiechman

  • Nurse Practitioner
  • Brooklyn Center, MN
National Provider Identifier
1013419969
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5871 Issued in MN
Practice address
5615 Xerxes Ave N Ste D
Brooklyn Center, MN 55430
Phone
(763) 581-5630
Fax
(763) 581-5631
NPI assigned
Mar 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5871 MN Primary

Addresses

Primary practice location

5615 Xerxes Ave N Ste D
Brooklyn Center, MN 55430

Mailing address

5615 Xerxes Ave N Ste D
Brooklyn Center, MN 55430-2820
Phone (763) 581-5630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180706001370 MN Practitioner - Nurse Practitioner 6305192261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

15450 Hwy 7
Minnetonka, MN 55345-3522

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (651) 430-3800

4209 Webber Pkwy
Minneapolis, MN 55412-1747
Phone (763) 581-2273

8100 42ND Ave N
New Hope, MN 55427-1107
Phone (763) 581-2273

8301 Golden Valley Rd
Suite 100
Golden Valley, MN 55427-4469
Phone (763) 581-2273

8559 Edinbrook Pkwy
Suite 100
Brooklyn Park, MN 55443-3728
Phone (763) 581-2273

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5871MNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2018 Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

5615 Xerxes Ave N
Brooklyn Center, MN 55430
Phone (763) 581-5630

5615 Xerxes Ave N
Ste D
Brooklyn Center, MN 55430
Phone (763) 581-5630

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

9825 Hospital Dr
Ste 200
Maple Grove, MN 55369
Phone (763) 581-5400

4209 Webber Pkwy
Minneapolis, MN 55412
Phone (763) 553-0544

15450 Highway 7
Ste 225
Minnetonka, MN 55345
Phone (612) 756-8008

3300 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 520-2000

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2600 39th Ave NE
Saint Anthony, MN 55421
Phone (612) 706-2690

Interoperability endpoints

  • Direct secure messaging: awiechman8305@direct.northmemorial.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1013419969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 XERXES AVE N STE D",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302820",
            "telephone_number": "763-581-5630",
            "fax_number": "763-581-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 XERXES AVE N STE D",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "55430",
            "telephone_number": "763-581-5630",
            "fax_number": "763-581-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECHMAN",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.