Individual provider Active NPI

Lydia Weyenberg, MD

  • Obstetrics & Gynecology Physician
  • Bellevue, WA
National Provider Identifier
1407381650
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
68481 Issued in AZ
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5000
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 68481 AZ Primary
Obstetrics & Gynecology Physician 207V00000X MD61151043 WA
Hospitalist Physician 208M00000X MD61151043 WA
Obstetrics & Gynecology Physician 207V00000X 13305389-1205 UT

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323 ext. 1180

Other identifiers 1

IdentifierTypeStateIssuer
68481OtherAZARIZONA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, WI, HI, IL, VT, NM6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20220304001784 WA Practitioner - HospitalistPractitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 2 organizations
I20230112001014 WI Practitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 2 organizations
I20240208004111 HI Practitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 1 organization
I20240521001392 IL Practitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 2 organizations
I20240625004050 VT Practitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 1 organization
I20250424002448 NM Practitioner - Obstetrics/Gynecology 4486048592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323

2520 S Telshor Blvd
Las Cruces, NM 88011-4907
Phone (575) 522-9793

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13305389-1205UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Jan 2, 2024 Accepting new patients
Central Dupage Physician Group Hospitalist CurrentSince Jun 15, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Aspirus Medical Group, Inc. Obstetrics & Gynecology CurrentSince Jul 9, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Jun 15, 2024 Accepting new patients
Northwestern Medical Center Inc CurrentSince Jun 5, 2024 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology Current Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Apr 2, 2025 Accepting new patients
Obhg Washington, PC Obstetrics & Gynecology CurrentSince Jan 1, 2025 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Apr 2, 2025 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology CurrentSince Feb 27, 2023 Accepting new patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Feb 1, 2025 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 9, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc CurrentSince Jun 5, 2024 Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology CurrentSince Feb 27, 2023 Accepting new patients
Valley Medical Group-Renton Hospitalist CurrentSince Mar 1, 2022 Accepting new patients
Northwestern Medical Center Inc Past Accepting new patients
Las Cruces Physician Practices, LLC Obstetrics & Gynecology Past Accepting new patients
Mariposa Community Health Center, Inc Obstetrics & Gynecology PastSince Feb 27, 2023 Accepting new patients

Locations (25 of 29)

1209 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3135

1209 W Target Range Rd
Ste 100
Nogales, AZ 85621
Phone (520) 287-4747

1852 N Mastick Way
Nogales, AZ 85621

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1103 Circulo Mercado
Ste E
Rio Rico, AZ 85648
Phone 52028115501307

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

80 Mahalani St
Wailuku, HI 96793
Phone (808) 243-6000

Dept 5777
Carol Stream, IL 60122

29980 Network Pl
Chicago, IL 60673

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

2520 S Telshor Blvd
Las Cruces, NM 88011
Phone (575) 522-9793

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: lydia.weyenberg.1@19849.direct.athenahealth.com

Organizations & group practices 24

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 24

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1407381650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "815-356-2323 x1180",
            "fax_number": "520-281-1112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYENBERG",
        "first_name": "LYDIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "68481",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD61151043",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD61151043",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "13305389-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL BOARD",
            "identifier": "68481",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.