Individual provider Active NPI

Robby J Wiemer, DPM

  • Foot & Ankle Surgery Podiatrist
  • Havertown, PA
National Provider Identifier
1275532079
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC004761L Issued in PA
Practice address
850 W Chester Pike
Suite 200
Havertown, PA 19083-4400
Phone
(484) 453-8164
Fax
(484) 453-8291
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC004761L PA Primary

Addresses

Primary practice location

850 W Chester Pike
Suite 200
Havertown, PA 19083-4400

Mailing address

850 W Chester Pike
Suite 200
Havertown, PA 19083-4400
Phone (484) 453-8164

Other identifiers 1

IdentifierTypeStateIssuer
00018271290002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080123000726 PA Practitioner - Podiatry 0345322806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 W Chester Pike
Havertown, PA 19083-4442
Phone (484) 832-6154

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 tissue129
Removal of skin lesions1-10
Removal of nail tissue1547
Removal or shaving of skin growth1109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC004761LPAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wiemer Family Podiatry, LLC CurrentSince Jan 7, 2008 Accepting new patients
Sam Surgery Center, LLC Past Accepting new patients
A Foot Above Podiatry, Inc. Foot & Ankle Surgery Past Accepting new patients
Edward E Villanueva DPM Foot & Ankle Surgery Past Accepting new patients

Locations

850 W Chester Pike
Ste 200
Havertown, PA 19083
Phone (484) 453-8164

850 W Chester Pike
Ste 301
Havertown, PA 19083
Phone (484) 832-6154

Organizations & group practices 4

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1275532079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W CHESTER PIKE",
            "address_2": "SUITE 200",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834400",
            "telephone_number": "484-453-8164",
            "fax_number": "484-453-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W CHESTER PIKE",
            "address_2": "SUITE 200",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834400",
            "telephone_number": "484-453-8164",
            "fax_number": "484-453-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMER",
        "first_name": "ROBBY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC004761L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018271290002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.