Individual provider Active NPI

Jason Andrew Wiechert, D.O.

  • Orthopaedic Surgery Physician
  • Belleville, IL
National Provider Identifier
1235545971
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036150728 Issued in IL
Practice address
4700 Memorial Dr Ste 340
Belleville, IL 62226-5373
Phone
(618) 234-9884
NPI assigned
Jul 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036150728 IL Primary
Orthopaedic Surgery Physician 207X00000X 2014022165 MO
Orthopaedic Surgery Physician 207X00000X 5101023734 MI

Addresses

Primary practice location

4700 Memorial Dr Ste 340
Belleville, IL 62226-5373

Mailing address

4700 Memorial Dr Ste 340
Belleville, IL 62226-5373
Phone (618) 234-9884

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, 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
I20180713000742 MI Practitioner - Orthopedic Surgery 3678829132 Reassigns benefits to 1 organization
I20200115002232 IL Practitioner - Orthopedic Surgery 3678829132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

4700 Memorial Dr
Belleville, IL 62226-5373

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, O Fallon, IL, CCN 148004
  • Apollo Medical Home health agency, Saint Louis, MO, CCN 267580
  • Elara Caring V Home health agency, Springfield, IL, CCN 148086
  • Memorial Hospital Hospital, Belleville, IL, CCN 140185
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement24
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150728ILMDOrthopaedic Surgery Physician
5101023734MIMDOrthopaedic Surgery Physician
2014022165MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Dec 7, 2019 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Sep 14, 2018 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Dec 7, 2019 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4700 Memorial Dr
Ste 350
Belleville, IL 62226
Phone (618) 235-7065

4700 Memorial Dr
Ste 340
Belleville, IL 62226
Phone (618) 234-9884

4700 Memorial Dr
Ste 300
Belleville, IL 62226
Phone (618) 234-9884

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3601 W 13 Mile Rd
Royal Oak, MI 48073

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

Interoperability endpoints

  • Direct secure messaging: jwiechert1067489@direct.carenet.org

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 5

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1235545971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR STE 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265373",
            "telephone_number": "618-234-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR STE 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265373",
            "telephone_number": "618-234-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECHERT",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036150728",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2014022165",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101023734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4700 Memorial Dr Ste 340",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.