Individual provider Active NPI

Sarah E Wiegman, PA-C

  • Medical Physician Assistant
  • Maryville, IL
National Provider Identifier
1285439620
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6800 State Route 162
Maryville, IL 62062-8500
Phone
(618) 288-5711
NPI assigned
Feb 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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 IL Primary

Addresses

Primary practice location

6800 State Route 162
Maryville, IL 62062-8500

Mailing address

380 Denick Loop
Pocahontas, IL 62275-3665
Phone (618) 499-4890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250529001165 IL Practitioner - Physician Assistant 9133648538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

6800 State Route 162
Maryville, IL 62062-8500
Phone 6182885711402

6810 State Route 162
Maryville, IL 62062-8501
Phone (618) 288-5711

6812 State Route 162
Maryville, IL 62062-8553

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC CurrentSince May 19, 2025 Accepting new patients

Locations

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6810 State Route 162
Ste 100
Maryville, IL 62062
Phone (618) 288-3616

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

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 1

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": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1285439620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 DENICK LOOP",
            "city": "POCAHONTAS",
            "state": "IL",
            "postal_code": "622753665",
            "telephone_number": "618-499-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628500",
            "telephone_number": "618-288-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGMAN",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.