Individual provider Active NPI

Wissam Bleibel, M.D.

  • Gastroenterology Physician
  • Oregon, OH
National Provider Identifier
1558477489
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01095562A Issued in IN
Practice address
2702 Navarre Ave
Suite 320
Oregon, OH 43616-3223
Phone
(419) 696-5555
Fax
(419) 696-8499
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 44628 KY
Gastroenterology Physician 207RG0100X 0101245745 VA
Gastroenterology Physician 207RG0100X 35128599 OH
Gastroenterology Physician 207RG0100X 01095562A IN Primary

Addresses

Primary practice location

2702 Navarre Ave
Suite 320
Oregon, OH 43616-3223

Mailing address

2200 Jefferson Ave
5TH FL
Toledo, OH 43604-7101

Other practice location 1

824 N Military Hwy Ste 100
Norfolk, VA 23502-3652
Phone (888) 236-2263

Other practice location 2

11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 46845-1733
Phone (260) 266-5230

Other identifiers 2

IdentifierTypeStateIssuer
0172563MedicaidOH
7100227260MedicaidKY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address wbleibel115312@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, ME2 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
I20250207002749 IN Practitioner - Gastroenterology 9830199637 Reassigns benefits to 1 organization
I20260303002468 ME Practitioner - Gastroenterology 9830199637 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35128599OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System,Inc. Gastroenterology CurrentSince Feb 10, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince Jan 6, 2026 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Eastern Maine Medical Center CurrentSince Jan 6, 2026 Accepting new patients
Primedoc of Richmond PC Past Accepting new patients

Locations

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

11104 Parkview Circle Dr
Ste 310
Fort Wayne, IN 46845
Phone (260) 266-5230

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

489 State St
Bangor, ME 04401
Phone (207) 973-8837

417 State St
Ste 121
Bangor, ME 04401
Phone (207) 947-0147

Interoperability endpoints

  • Direct secure messaging: wbleibel115312@direct.parkviewexchange.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System Inc 1,350 clinicians
Eastern Maine Medical Center 659 clinicians

Practice addresses (Care Compare)

11104 Parkview Circle Dr
Fort Wayne, IN 46845-1672
Phone (206) 266-5400

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 425-6030

11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 672-6443

2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone (260) 425-6030

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux16

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1558477489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "5TH FL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 NAVARRE AVE",
            "address_2": "SUITE 320",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163223",
            "telephone_number": "419-696-5555",
            "fax_number": "419-696-8499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 N Military Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235023652",
            "country_code": "US",
            "telephone_number": "888-236-2263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451733",
            "country_code": "US",
            "telephone_number": "260-266-5230",
            "fax_number": "260-458-5972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEIBEL",
        "first_name": "WISSAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "44628",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101245745",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35128599",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01095562A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172563",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100227260",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wbleibel115312@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.