Individual provider Active NPI

Katrina Weimer, M.D.

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1083148464
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70234-20 Issued in WI
Practice address
3209 Dryden Dr
Madison, WI 53704-3015
Phone
(608) 241-9020
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.152795 IL
Family Medicine Physician 207Q00000X 70234-20 WI Primary
Emergency Medicine Physician 207P00000X 70234-20 WI

Addresses

Primary practice location

3209 Dryden Dr
Madison, WI 53704-3015

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000

Other practice location 2

14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Other identifiers 1

IdentifierTypeStateIssuer
1083148464MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kweimer264047@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191002000989 WI Practitioner - Family Practice 7911277751
I20200918000230 IL Practitioner - Family Practice 7911277751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, shared by 21 NPIs, 2,537 clinicians

Practice addresses (Care Compare)

14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005

3030 N Mobile Ave
Chicago, IL 60634-4041
Phone (773) 622-5679

3209 Dryden Dr
Madison, WI 53704-3015
Phone (608) 287-2770

5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 413-1920

5461 W Lake St
Chicago, IL 60644-2342
Phone 7083830113220005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70234-20WIMDEmergency Medicine Physician
036.152795ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Jul 15, 2020 Accepting new patients
PCC Community Wellness Center CurrentSince Jul 15, 2020 Accepting new patients
PCC Community Wellness Center Past Accepting new patients

Locations

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Interoperability endpoints

  • Direct secure messaging: katrina.weimer.1@13158.direct.athenahealth.com
  • Direct secure messaging: kweimer264047@direct-ehr-ssmhc.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.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1083148464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 DRYDEN DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043015",
            "telephone_number": "608-241-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1821 S Stoughton Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537162257",
            "country_code": "US",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Lake St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022606",
            "country_code": "US",
            "telephone_number": "708-383-0113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "KATRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.152795",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "70234-20",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "70234-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083148464",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kweimer264047@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kweimer264047@direct-ehr-ssmhc.com",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.