Cheryl A Wesen, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301062525 Issued in MI

Practice address

19229 Mack Ave
Ste 34
Grosse Pointe Woods, MI 48236-2858

Phone

(313) 647-3912

Fax

(313) 347-3902

NPI assigned

Jan 5, 2006

Last updated

Feb 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Semi Medical Group

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  • NPI 1114133485

  Surgery

  Medicare reassignment NPD
• Henry Ford Semi Medical Group

  • Surgery Physician
  • Detroit, MI
  • NPI 1629272968
  NPD
• Lloyd and Boccaccio MD PC

  dba St Clair Surgical Specialists

  • Specialist
  • Grosse Pointe Woods, MI
  • NPI 1326179730
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1255319729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE",
            "address_2": "STE 34",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362858",
            "telephone_number": "313-647-3912",
            "fax_number": "313-647-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE",
            "address_2": "STE 34",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362858",
            "telephone_number": "313-647-3912",
            "fax_number": "313-347-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESEN",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301062525",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MI",
            "license": "4301062525",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4816915",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "0H231320",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3475787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Weiss, LPC
• Wellspring Dental
• Welltower Opco Group LLC (Sunrise on Vernier)
• Welltower Opco Group LLC (Sunrise of Grosse Pointe Woods)
• Michael Mulraney Welsh
• Harrison McHale Westmore, AU.D.
• Anquniece Chene Wheeler
• Brittany Danielle Wilkerson
• Sierra Nicole Wilkerson
• Amanda M Wilkins, LMT

• Surgery Physician in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.