NPIMap

Individual provider Active NPI

Amelie M Wegner, MD

  • Family Medicine Physician
  • Molalla, OR
National Provider Identifier
1285067132
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD194762 Issued in OR
Practice address
110 Center Ave
Molalla, OR 97038-8134
Phone
(503) 829-1400
NPI assigned
Aug 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Family Medicine Physician 207Q00000X MD194762 OR Primary

Addresses

Primary practice location

110 Center Ave
Molalla, OR 97038-8134

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

Msc 09 5040
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-6607

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awegner478243@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190924002255 OR Practitioner - Family Practice 3476847849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

110 Ctr Ave
Molalla, OR 97038-8134
Phone (503) 829-2273

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 1, 2019 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: awegner478243@oc.providencedirect.org

Organizations & group practices 5

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 9

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1285067132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CENTER AVE",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970388134",
            "telephone_number": "503-829-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc 09 5040",
            "address_2": "1 University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-6607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "AMELIE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD194762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awegner478243@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "110 Center Ave",
            "city": "Molalla",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970388134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Molalla, OR

Sources for this page

Verify at the official NPI Registry.