Amy L Wiesch, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016005119 Issued in IL

Practice address

11 Briarcliff Prof Ctr
Bourbonnais, IL 60914-1775

Phone

(815) 933-7077

Fax

(815) 933-4430

NPI assigned

Oct 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Foot and Ankle Clinics PCGroup PAC ID 5193744845, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155

Merit-based Incentive Payment System (MIPS)

Final score

81.44 of 100Reported as individual

Quality

60.56

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Associated Foot and Ankle Clinics, PC

  • Podiatrist
  • Streator, IL
  • NPI 1730323817
  Medicare reassignment Care Compare group NPD
• Associated Foot and Ankle Clinics, PC

  • Podiatrist
  • Bourbonnais, IL
  • NPI 1295723435
  NPD
• Presence Service Corporation

  • Family Medicine Physician
  • Bolingbrook, IL
  • NPI 1831204536
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1396733549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E HICKORY ST",
            "address_2": "SUITE 2",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642287",
            "telephone_number": "815-672-0280",
            "fax_number": "815-672-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BRIARCLIFF PROF CTR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141775",
            "telephone_number": "815-933-7077",
            "fax_number": "815-933-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESCH",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Fredrick Werner, ATC
• Aaron Michael Wheeler, LCPC
• Shaun Wheeler, DPT, PT
• Kimberly K White, FNP-BC
• Emily Whitlow, LCPC
• Amy Jean Wiley, MA LCPC
• Bradley Wilfong
• Carolyne Wilkey
• Bryann Marie Williams, MSW/LSW
• Janette Renee Williams, LCPC

• Podiatrist in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.