Individual provider Active NPI

Gregory L. Wiemken, DPM

  • Podiatrist
  • Strongsville, OH
National Provider Identifier
1104969609
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2702 Issued in OH
Practice address
15294 Pearl Rd
Strongsville, OH 44136-5021
Phone
(440) 238-1560
Fax
(440) 238-9091
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2702 OH Primary

Addresses

Primary practice location

15294 Pearl Rd
Strongsville, OH 44136-5021

Mailing address

16000 Pearl Rd Ste 105
Strongsville, OH 44136-6094
Phone (440) 238-1560

Other identifiers 2

IdentifierTypeStateIssuer
0827109MedicaidOH
480029644OtherOHRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000562 OH Practitioner - Podiatry 4385768308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory L. Wiemken, DPM, Inc.Group PAC ID 0840314860, 2 clinicians

Practice addresses (Care Compare)

15294 Pearl Rd
Strongsville, OH 44136-5021
Phone (440) 238-1560

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue43
Removal of skin lesions21
Removal of nail tissue1003
Removal or shaving of skin growth531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2702OHMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: gwiemken@direct.swgeneral.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Altenheim Nursing HomeStrongsville, OH, CCN 365109 Skilled nursing facility Corporate Director (6.66%) Jun 24, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1104969609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 PEARL RD STE 105",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366094",
            "telephone_number": "440-238-1560",
            "fax_number": "440-238-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15294 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441365021",
            "telephone_number": "440-238-1560",
            "fax_number": "440-238-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMKEN",
        "first_name": "GREGORY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "2702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827109",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480029644",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.