Individual provider Active NPI

Jeffery Wieland, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chardon, OH
National Provider Identifier
1578568093
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36-00-3359 Issued in OH
Practice address
325 Center St
Ste 1
Chardon, OH 44024
Phone
(440) 285-2666
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36-00-3359 OH Primary

Addresses

Primary practice location

325 Center St
Ste 1
Chardon, OH 44024

Mailing address

PO Box 483
Chardon, OH 44024-0483
Phone (440) 285-2666

Other identifiers 1

IdentifierTypeStateIssuer
2426682MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20050428000738 OH Practitioner - Podiatry 3274572235 Reassigns benefits to 2 organizations
Practice locations: Chardon, OH; Orwell, OH

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Clinical Services LLCGroup PAC ID 5991177313, 49 clinicians
Wound Care Consultants LLCGroup PAC ID 2567646359, 29 clinicians

Practice addresses (Care Compare)

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (216) 331-6750

6789 Ridge Rd
Suite 305
Parma, OH 44129-5635
Phone (440) 491-8334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue656
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Care Consultants LLC Foot & Ankle Surgery CurrentSince Dec 15, 2011 Accepting new patients
Encore Clinical Services LLC CurrentSince Dec 1, 2025 Accepting new patients
Lake Effect Health Current Accepting new patients
Lake County Foot & Ankle Associates, LLC Foot & Ankle Surgery PastSince Aug 1, 2004 Accepting new patients
Lake County Foot & Ankle Associates, LLC Foot & Ankle Surgery Past Accepting new patients
Precision Orthopaedic Specailties, Inc. Foot & Ankle Surgery Past Accepting new patients

Locations

12301 Ridge Rd
North Royalton, OH 44133
Phone (216) 331-6750

6789 Ridge Rd
Ste 305
Parma, OH 44129
Phone (440) 491-8334

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.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1578568093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440240483",
            "telephone_number": "440-285-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CENTER ST",
            "address_2": "STE 1",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "440-285-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "JEFFERY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36-00-3359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2426682",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.