Individual provider Active NPI

Michael Murphy Weedman, PA-C

  • Physician Assistant
  • Rockford, IL
National Provider Identifier
1023790862
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009963 Issued in IL
Practice address
324 Roxbury Rd
Rockford, IL 61107-5090
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Aug 2, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085009963 IL Primary

Addresses

Primary practice location

324 Roxbury Rd
Rockford, IL 61107-5090

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230920002644 IL Practitioner - Physician Assistant 0244684561 Reassigns benefits to 1 organization
I20250606002175 WI Practitioner - Physician Assistant 0244684561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

324 Roxbury Rd
Rockford, IL 61107-5090
Phone (815) 398-9491

770 Beloit Rd
Belvidere, IL 61008-1745
Phone (815) 398-9491

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100Reported as group
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085009963ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Physician Assistant CurrentSince Oct 2, 2023 Accepting new patients
Orthomidwest, PLLC CurrentSince Oct 2, 2023 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

8400 Lakeview Pkwy
Ste 800
Pleasant Prairie, WI 53158
Phone (262) 455-7548

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIHAAA

Organizations & group practices 2

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 2

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": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1023790862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDMAN",
        "first_name": "MICHAEL",
        "middle_name": "MURPHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.