NPIMap

Organization Active NPI

Wiegandt and Associates PC

  • Exclusive Provider Organization
  • Wareham, MA
National Provider Identifier
1306133475
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
57120 Issued in MA
Legal business name
WIEGANDT AND ASSOCIATES PC
Practice address
2621 Cranberry Hwy
Wareham, MA 02571-1004
Phone
(508) 295-4902
Fax
(508) 295-2455
NPI assigned
Jul 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Lizbeth Kay Estes
Title
Office Manager
Phone
(508) 295-4902

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 57120 MA
Exclusive Provider Organization 302F00000X 57120 MA Primary

Addresses

Primary practice location

2621 Cranberry Hwy
Wareham, MA 02571-1004

Mailing address

2621 Cranberry Hwy
Wareham, MA 02571-1004
Phone (508) 295-4902

Other identifiers 1

IdentifierTypeStateIssuer
1285692525MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131015000026 MA Part B Supplier - Clinic/Group Practice 3375777931 Receives reassigned benefits from 10 practitioners
Practice locations: Wareham, MA

National Provider Directory

National Provider Directory

Locations

15 Mill St
Marion, MA 02738
Phone (508) 748-3830

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1306133475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 CRANBERRY HWY",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711004",
            "telephone_number": "508-295-4902",
            "fax_number": "508-295-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 CRANBERRY HWY",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711004",
            "telephone_number": "508-295-4902",
            "fax_number": "508-295-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIEGANDT AND ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "ESTES",
        "authorized_official_first_name": "LIZBETH",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "508-295-4902"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "57120",
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "57120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285692525",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.