Individual provider Active NPI

Joshua Wietholder, PA-C

  • Medical Physician Assistant
  • Monroeville, PA
National Provider Identifier
1285221598
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA062197 Issued in PA
Practice address
125 Daugherty Dr Ste 305
Monroeville, PA 15146-2749
Phone
(412) 856-4666
NPI assigned
Dec 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA062197 PA Primary

Addresses

Primary practice location

125 Daugherty Dr Ste 305
Monroeville, PA 15146-2749

Mailing address

125 Daugherty Dr Ste 305
Monroeville, PA 15146-2749
Phone (412) 856-4666

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250707001972 PA Practitioner - Physician Assistant 8426562174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Cardiovascular Medicine PCGroup PAC ID 9234110685, 6 clinicians

Practice addresses (Care Compare)

125 Daugherty Dr
Suite 301
Monroeville, PA 15146-2749
Phone (412) 856-4666

Hospital & facility affiliations

  • Upmc Presbyterian Shadyside Hospital, Pittsburgh, PA, CCN 390164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA062197PAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jwietholder@specialists.medentdirect.com

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.

Hospital & facility affiliations 4

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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1285221598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DAUGHERTY DR STE 305",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462749",
            "telephone_number": "412-856-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DAUGHERTY DR STE 305",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462749",
            "telephone_number": "412-856-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETHOLDER",
        "first_name": "JOSHUA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA062197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.