Individual provider Active NPI

Mark D Weissman, M.D.

  • Emergency Medicine Physician
  • Marinette, WI
National Provider Identifier
1366426538
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33134020 Issued in WI
Practice address
3003 University Dr
Marinette, WI 54143-4110
Phone
(715) 735-4200
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01040184A IN
Emergency Medicine Physician 207P00000X 33134020 WI Primary

Addresses

Primary practice location

3003 University Dr
Marinette, WI 54143-4110

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

10400 75th St
Aurora Medical Center
Kenosha, WI 53142-7884
Phone (262) 697-7000

Other practice location 2

100 County Road B
Shawano, WI 54166-7072
Phone (715) 524-2161

Other identifiers 1

IdentifierTypeStateIssuer
31806700MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mweissman171265@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040813000380 IL Practitioner - Emergency Medicine 9133022890 Reassigns benefits to 5 organizations
I20150618000437 WI Practitioner - Emergency Medicine 9133022890 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare Medical Center - Shawano, Inc.Group PAC ID 5890605836, 38 clinicians
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

100 County Rd B
Shawano, WI 54166-7072
Phone (715) 526-2111

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

Hospital & facility affiliations

  • Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346
  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113
  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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 Medicine

State licenses

LicenseStateTypeSpecialty
33134020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 5, 2025 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 5, 2025 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Thedacare Regional Medical Center - Appleton, Inc. CurrentSince Apr 16, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Em Strategies,LTD. Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Rockford Health Physicians CurrentSince Apr 15, 2017 Accepting new patients
Thedacare Medical Center - Wild Rose, Inc CurrentSince Apr 5, 2024 Accepting new patients
MD @ Home Illinois, SC CurrentSince Jun 30, 2021 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Emergency Physician Associates of Wisconsin SC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Apr 5, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Dietitians at Home Inc CurrentSince Apr 1, 2010 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Emergency Medicine CurrentSince Apr 5, 2024 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jan 3, 2026 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Apr 5, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Thedacare Regional Medical Center - Appleton Inc. CurrentSince Apr 16, 2025 Accepting new patients
Thedacare Regional Medical Center - Appleton, Inc. Current Accepting new patients
Home Physicians PC PastSince Jan 1, 2007 Accepting new patients
Dietitians at Home Therapeutic Shoes, LLC PastSince Jun 30, 2021 Accepting new patients
Mea-Aea Kenosha SC Emergency Medicine Past Accepting new patients
Home Physicians Baltimore, PC PastSince Apr 30, 2003 Accepting new patients
Chicago Healthworks Past Accepting new patients

Locations (25 of 32)

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2003 W Fulton St
Ste 105
Chicago, IL 60612
Phone (312) 850-3437

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

12701 W 143rd St
Lockport, IL 60491
Phone (708) 364-6337

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

755 W Johnson St
Fond du Lac, WI 54935
Phone (920) 731-4101

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

3100 Shore Dr
Marinette, WI 54143
Phone (715) 735-4200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

Interoperability endpoints

  • Direct secure messaging: mark.weissman.1@3342.direct.athenahealth.com
  • Direct secure messaging: mweissman338651@direct.thedacare.org
  • Direct secure messaging: mweissman171265@direct.myadvocateaurora.org

Organizations & group practices 32

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.

View all 32

Hospital & facility affiliations 6

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1366426538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 UNIVERSITY DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434110",
            "telephone_number": "715-735-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 75th St",
            "address_2": "Aurora Medical Center",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427884",
            "country_code": "US",
            "telephone_number": "262-697-7000",
            "fax_number": "630-734-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 County Road B",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541667072",
            "country_code": "US",
            "telephone_number": "715-524-2161",
            "fax_number": "715-526-7308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01040184A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "33134020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31806700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mweissman171265@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3003 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3003 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.