Individual provider Active NPI

Marc F Weisman, DO

  • Family Medicine Physician
  • Madison Heights, MI
National Provider Identifier
1356443600
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101008700 Issued in MI
Practice address
1200 W 12 Mile Rd
Madison Heights, MI 48071
Phone
(248) 543-0600
Fax
(248) 543-4720
NPI assigned
Sep 5, 2006
Last updated
Jun 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101008700 MI Primary

Addresses

Primary practice location

1200 W 12 Mile Rd
Madison Heights, MI 48071

Mailing address

1200 W 12 Mile Rd
Madison Heights, MI 48071
Phone (248) 543-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000688 MI Practitioner - Family PracticePractitioner - Geriatric Medicine 3072521335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
College of Physicians and Surgeons (Iowa), 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 W Twelve Mile Rd
Preferred Medical Group
Madison Heights, MI 48071-4439
Phone (248) 543-0600

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008700MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Oct 1, 2015 Accepting new patients
Michigan Healthcare Professionals PC Family Medicine Current Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Oct 1, 2015 Accepting new patients
NDS Radiology Inc. Family Medicine Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1200 W 12 Mile Rd
Madison Hts, MI 48071
Phone (248) 291-5236

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3601 W 13 Mile Rd
Royal Oak, MI 48073

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: marc.weisman.1@26235.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1356443600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-543-0600",
            "fax_number": "248-543-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-543-0600",
            "fax_number": "248-543-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISMAN",
        "first_name": "MARC",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.